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)
Unmc Physicians
Jonathan Cramer is a Cardiologist and a Pediatric Cardiologist practicing medicine in Omaha, Nebraska. He has been practicing medicine for over 20 years. Dr. Cramer is rated as an Advanced provider by MediFind in the treatment of Anomalous Left Coronary Artery from the Pulmonary Artery. He is also highly rated in 11 other conditions, according to our data. His clinical expertise encompasses Transposition of the Great Arteries, Eisenmenger Syndrome, Anomalous Left Coronary Artery from the Pulmonary Artery, Endocardial Cushion Defect, and Heart Transplant.
OSF Saint Katharine - Cardiology
Monther Bzour is a Cardiologist and a Nuclear Medicine provider practicing medicine in Dixon, Illinois. Dr. Bzour is rated as an Advanced provider by MediFind in the treatment of Anomalous Left Coronary Artery from the Pulmonary Artery. He is also highly rated in 67 other conditions, according to our data. His clinical expertise encompasses Coronary Heart Disease, Atherosclerosis, Angina, Atrial Fibrillation, and Pacemaker Implantation. Dr. Bzour is board certified in American Board Of Internal Medicine and Certification Board Of Nuclear Cardiology.
Department Of Cardiac Surgery
Sitaram Emani is a General Surgeon practicing medicine 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. He is also highly rated in 33 other conditions, according to our data. His clinical expertise encompasses Partial Atrioventricular Canal, Ventricular Septal Defects, Endocardial Fibroelastosis, Heart Transplant, and Lung Transplant.
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.
Brothers JA, Gaynor JW. Surgery for congenital anomalies of the coronary arteries. In: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston and Spencer Surgery of the Chest. 10th ed. Philadelphia, PA: Elsevier; 2024:chap 129.
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.