Anomalous Left Coronary Artery from the Pulmonary ArterySymptoms, Doctors, Treatments, Advances & More
Learn About Anomalous Left Coronary Artery from the Pulmonary Artery
Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a heart defect. The left coronary artery (LCA), which carries blood to the heart muscle, begins from the pulmonary artery instead of the aorta.
ALCAPA is present at birth (congenital).
Anomalous origin of the left coronary artery arising from the pulmonary artery; ALCAPA; ALCAPA syndrome; Bland-White-Garland syndrome; Congenital heart defect - ALCAPA; Birth defect - ALCAPA
ALCAPA is a problem that occurs when the baby's heart is developing early in the pregnancy. The developing blood vessel does not attach correctly to the heart muscle.
In the normal heart, the LCA originates from the aorta. It supplies oxygen-rich blood to the heart muscle on the left side of the heart as well as the mitral valve (the heart valve between the upper and lower chambers of the heart on the left side). The aorta is the major blood vessel that takes oxygen-rich blood from the heart to the rest of the body.
In children with ALCAPA, the LCA originates from the pulmonary artery. The pulmonary artery is the major blood vessel that takes oxygen-poor blood from the heart to the lungs to pick up oxygen.
When ALCAPA occurs, blood that is lacking in oxygen is carried to the heart muscle on the left side of the heart. Therefore, the heart muscle does not get enough oxygen. The tissue begins to die due to lack of oxygen. This can cause a heart attack in a baby.
A condition known as coronary steal further damages the heart in babies with ALCAPA. The low blood pressure in the pulmonary artery causes blood from the abnormally connected LCA to flow back toward the pulmonary artery instead of toward the heart muscle. This results in less blood and oxygen to the heart muscle. This problem can also lead to a heart attack in a baby. Coronary steal develops over time in babies with ALCAPA if the condition is not treated early.
Symptoms of ALCAPA in an infant include:
- Crying or sweating during feeding
- Irritability
- Pale skin
- Poor feeding
- Rapid breathing
- Symptoms of pain or distress in the baby (often mistaken for colic)
Symptoms can appear within the first 2 months of the baby's life.
Surgery is needed to correct ALCAPA. Only one surgery is needed in most cases. However, the surgery will depend on the baby's condition and the size of the involved blood vessels.
If the heart muscle supporting the mitral valve is seriously damaged from decreased oxygen, the baby may also need surgery to repair or replace the valve. The mitral valve controls blood flow between the chambers on the left side of the heart.
A heart transplant can be done in case the baby's heart is severely damaged due to lack of oxygen.
Medicines used include:
- Water pills (diuretics)
- Medicines that make the heart muscle pump harder (inotropic agents)
- Medicines that lower the workload on the heart (beta-blockers, ACE inhibitors)
Department Of Cardiac Surgery
Sitaram Emani is a General Surgeon in Boston, Massachusetts. Dr. Emani is rated as an Elite provider by MediFind in the treatment of Anomalous Left Coronary Artery from the Pulmonary Artery. His top areas of expertise are Partial Atrioventricular Canal, Endocardial Fibroelastosis, Ventricular Septal Defects, Heart Transplant, and Lung Transplant.
Texas Health Heart And Vascular Specialists
Brandie Williams, M.D., graduated with honors in biochemistry from Angelo State University in San Angelo, Texas. After receiving her medical degree from the American University of the Caribbean School of Medicine in St. Maarten, Netherlands Antilles, she completed her residency training in internal medicine — and fellowship training in cardiology — at the University of Texas Medical Branch in Galveston. She is board-certified in internal medicine and echocardiography.Williams has earned several humanitarian awards, including the Gold DOC Award from The Arnold P. Gold Foundation for her exemplary sensitivity, compassion and clinical excellence in the care of patients and their families. Her areas of focus include diagnostic heart catheterization, echocardiography, nuclear medicine and vascular studies, with special interests in women’s cardiovascular care, preventive cardiology and sports cardiology.Williams enjoys traveling and spending time with her husband and two children. Dr. Williams is rated as an Experienced provider by MediFind in the treatment of Anomalous Left Coronary Artery from the Pulmonary Artery. Her top areas of expertise are Aortic Regurgitation, Pediatric Myocarditis, Necrosis, and Glucocorticoid-Remediable Aldosteronism.
St. Christopher's Pediatric Associates Cardiology - Jenkintown
. Dr. Balluz is rated as an Experienced provider by MediFind in the treatment of Anomalous Left Coronary Artery from the Pulmonary Artery. Her top areas of expertise are Patent Ductus Arteriosus, Heart Murmurs, Ventricular Septal Defects, and Pulmonary Supravalvular Stenosis.
Without treatment, most babies do not survive their first year. Children who do survive without treatment may have serious heart problems. Babies with this problem who aren't treated could die suddenly during the following years.
With early treatment such as surgery, most babies do well and can expect a normal life. Routine follow-ups with a heart specialist (cardiologist) will be needed.
Complications of ALCAPA include:
- Heart attack
- Heart failure
- Heart rhythm problems
- Permanent damage to the heart
Contact your provider if your baby:
- Is breathing rapidly
- Looks very pale
- Seems distressed and cries often
Published Date: May 27, 2024
Published By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Gaudino M, Di Franco A, Arbustini E, et al. Management of adults with anomalous aortic origin of the coronary arteries: State-of-the-Art Review. J Am Coll Cardiol. 2023;82(21):2034-2053. PMID: 37855757 pubmed.ncbi.nlm.nih.gov/37855757/.
Johnson JT, Harris M, Anderson RH, et al. Congenital coronary anomalies. In: Wernovsky G, Anderson RH, Kumar K, et al, eds. Anderson's Pediatric Cardiology. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 46.
Kliegman RM, St. Geme JW, Blum NJ, et al. Other congenital heart and vascular malformations. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 481.