Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA)

What is ALCAPA?

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a congenital (present at birth) heart defect in which the left coronary artery arises abnormally from the pulmonary artery. Normally, the left and right coronary arteries arise from the aorta and supply blood with oxygen to the heart.

In children with ALCAPA, the left coronary artery arises from the pulmonary artery and carries blood without oxygen to the left side of the heart. When the heart doesn’t get enough oxygen, the heart muscle can weaken or die, similar to having a heart attack. The damaged heart muscle cannot pump effectively, leading to cardiomyopathy and heart failure.

ALCAPA is a very rare condition that may cause dangerously poor cardiac function in infancy. Surgery is needed to correct the defect. Without intervention, most babies don’t survive their first year, but with timely surgery, most babies do well and live a normal life.

What are the symptoms of ALCAPA?

Symptoms of anomalous left coronary artery from the pulmonary artery (ALCAPA) in an infant include:

  • crying or sweating during feeding
  • poor feeding
  • rapid breathing
  • sweating
  • symptoms of pain or distress (these are often mistaken for signs of colic)

Symptoms usually appear within the first few months of a baby's life.

How we care for ALCAPA

At Boston Children’s Hospital, our Benderson Family Heart Center provides expert screening, evaluation, and care for children with ALCAPA. Screening begins soon after your child’s first cardiac surgery and continues as your child grows.