Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) | Symptoms & Causes
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.
Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) | Diagnosis & Treatments
How is ALCAPA diagnosed?
If a doctor thinks your child has ALCAPA, he or she may order tests such as:
- chest x-ray
- electrocardiogram (ECK or EKG)
- echocardiogram (cardiac ultrasound)
- cardiac MRI
- cardiac catheterization
How is ALCAPA treated?
Surgery is needed to treat anomalous left coronary artery from the pulmonary artery (ALCAPA). Options for repair include detaching the anomalous left coronary artery from the pulmonary artery and moving it over to the aorta directly (translocation) or creating a natural tunnel from its abnormal location to the aorta (Takeuchi repair). If the mitral valve is leaking, it can be repaired at the same time. In some cases, the heart is severely damaged and may require mechanical circulatory/ventricular assist device support, and a heart transplant may be needed.
With timely therapy, most children do very well after surgery and can expect to live a normal life. However, routine and life-long follow-up with a heart-failure specialist will be necessary to ensure recovery of the heart muscle and good function of the mitral valve. Children born with ALCAPA are at an increased risk for heart-rhythm problems later in life.
What medications are used to treat ALCAPA?
Some children need medications prior to surgery in order to build up the strength necessary for the procedure. These medications may include:
- diuretics: “water pills”
- inotropic agents: medications that make the heart muscle pump harder
- beta-blockers, ACE inhibitors: medications that lower the work load on the heart
In addition, some of these medications may be needed after surgery.
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.
