Day: April 11, 2021

Infant with cough and decreased left ventricular ejection fraction

CXR and CT of anomalous left coronary artery from the pulmonary artery / ALCAPA
CXR AP (above) shows the left hemithorax is completely opacified with no mediastinal shift to the left and the pulmonary vascularity is congested. Axial CT with contrast of the chest (below) shows an extremely dilated left ventricle causing compression of the left mainstem bronchus and complete collapse of the left lung.

The diagnosis was anomalous left coronary artery from the pulmonary artery causing ischemic cardiomyopathy.