A case of anomalous origin of the left coronary artery presenting with XXXX and @entity65 .

@entity1 @entity712 @entity5988 @entity146 @entity384 @entity649 @entity26 @entity409 @entity2146 @entity381 @entity299 @entity1011 @entity583 @entity2401 @entity65
BACKGROUND: Though a rare clinical entity, anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) a common cause of @entity583 in @entity1 . Unrecognized and untreated it leads to progressive @entity5988 and @entity299 . In settings of high infectious burden, ALCAPA may erroneously be diagnosed as @entity2401 , @entity384 or other common childhood disorders. CLINICAL CASE: We present the case of a 10 weeks old male @entity1 who presented to the inpatient unit with marked @entity2146 and @entity146 . He was inconsolable, had marked @entity649 , cool extremities, central and peripheral cyanosis @entity26 . The radial and brachial pulses were absent. The mean arterial pressure was 65mmHg, Heart rate of 160 beats per minute with a third heart sound. The liver was enlarged 4cm below the costal margin and tender, with a @entity381 . He had an elevated @entity1011 Kinase-MB of 112.5 u/L. ECG revealed deep Q waves in leads I, aVL, V5, V6 with ST elevation in the anterolateral leads. Echo showed a dilated left ventricle LVEDd of 40mm, with paradoxical interventricular septal motion, severe @entity299 (FS=15%, EF=28%), LV anterolateral wall echo brightness and flow reversal in the Left coronary artery with its origin from the pulmonary trunk. He was admitted to the coronary care unit as a case of @entity583 with @entity65 . He received fluid resuscitation, inotropic support and standard management of @entity712 . Six days later he was discharged home with a plan to refer abroad. He died at home after one week. CONCLUSION: A combination of a high index of suspicion, typical ECG and echocardiographic findings in a young @entity1 presenting with @entity409 could lead to an earlier diagnosis of ALCAPA.
