Pediatric Anomalous Left Coronary Artery From the Pulmonary Artery

  • Etiology: Congenital
  • Imaging: Failure leads to acyanosis and increased pulmonary blood flow
  • Imaging: Left coronary artery arises from pulmonary artery and pulmonary steal develops off normal right coronary artery due to retrograde filling of left coronary artery from right coronary artery
  • DDX:
  • Complications: Congestive heart failure
  • Treatment:
  • Clinical:
    — Presents in neonate with congestive heart failure
    — Presents in older patients with myocardial ischemia or infarction

Radiology Cases of Anomalous Left Coronary Artery From the Pulmonary Artery

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.