CTICasesAnomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) in an Asymptomatic Adult
Imaging findings
CT reveals markedly dilated coronary arteries, calcification of the papillary muscles, and subendocardial fat deposition within the LAD territory. A timing bolus demonstrates left-to-right shunt physiology with early opacification of the pulmonary artery and a characteristic "puff" of non-opacified blood arising from the left coronary artery, indicating steal phenomenon. Myocardium also shows numerous small vessels.
Key takeaways
This is an impressive and rare case of Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) presenting in an asymptomatic, active adult, highlighting the potential for long-term survival due to extensive collateral development. The case beautifully demonstrates the physiology of ALCAPA on CT, including left-to-right shunting, coronary steal phenomenon, and signs of chronic myocardial ischemia.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Sarcoidosis Presenting as Emphysema in a Non-SmokerAutoimmune
- Large Coronary Artery Fistula from RCA to Right Atrium (Follow-up)Congenital
- Meandering Pulmonary Vein with Anomalous Connection to Right Innominate VeinCongenital
- Anomalous Left Main Coronary Artery Arising from RCA with Fistula to Coronary SinusCongenital
- Systemic-to-Pulmonary Venous Collaterals Secondary to Severe Pulmonary HypertensionVascular
- Adenocarcinoma in the Context of Fibrosing Lung DisorderNeoplastic
- Displaced Tongue Ring in the EsophagusIatrogenic
- Bronchiectasis with Thin Bronchial Walls (Possible Williams-Campbell Syndrome or Sjogren's Phenotype)Congenital
See all cases from September 9, 2016 →
Related Congenital cases
- RCA Sinoatrial Nodal Branch Fistula Draining to Right Atrium
- Bicuspid Pulmonic Valve with Main Pulmonary Artery Enlargement
- Absent Right Superior Vena Cava with Left Superior Vena Cava Draining to Coronary Sinus
- Infected Esophageal Duplication Cyst with Communication
- Left Lung Agenesis with Right Lung Extension into Left Hemithorax
- Aortic Coarctation with Sinus Venosus Atrial Septal Defect and Anomalous Pulmonary Venous Drainage