Diagnostic Accuracy of Echocardiography in ALCAPA: Is It Always Correct to Rely Only on Echocardiography? The Issue of False Negatives

The role of echocardiography in anomalous origin of coronary artery from pulmonary artery (ALCAPA): Simple tool for a complex diagnosis

Anomalous origin of coronary artery from pulmonary artery (ALCAPA) is a rare coronary anomaly usually presenting in the first year of life. Adult presentation suggests a wide range of differential diagnosis such as myocarditis, dilated cardiomyopathy, and coronary artery disease. We have presented here the major distinctive echocardiographic features of ALCAPA through 4 cases. Since echocardiography is often used as the first imaging modality in these clinical scenarios, recognizing the characteristics of ALCAPA in a routine echocardiographic examination can transform a readily available, low-cost tool into a valuable discriminative modality.

Staged surgery for an unusual combination of cardiac and tracheal anomalies

Herein, the case of an infant initially diagnosed with left pulmonary artery sling, ventricular septal defect and a small atrial septal defect is described. Further diagnostic work-up revealed tracheobronchial anomalies and the presence of an anomalous origin of the left coronary artery from the pulmonary artery. The staged surgical management is described.