A Case of Dilated Cardiomyopathy Secondary to Anomalous Left Coronary Artery Originating from the Pulmonary Artery

Anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) commonly presents in infancy with elinical features of congestive heart failure , dilated cardiomyopathy or cardiogenic shock. A 24-day-old female infant presented to the hospital with symptoms of respiratory distress, sweating and irritabi lity. She had severe congestive hearl fai lure. Further investigations revealed that she had severe dilated cardiomyopathy due to anomalous left coronary artery arising from main pulmonary artery. We present this case because of its rarity and difficulty in distinguishing clinically from dilated cardiomyopathy. ALCAPA must be thought in an infant with s igns of heart failure and dilated cardiomyopathy when there is echocardiographical evidence of left ventricular hypertrophy in addition to ventricular dilatation, fibrosis of the papillary muscles, and aneurysm formation in the apex.