Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA), Pediatric

Reviewed 06/2017



The anomalous coronary artery arises from the pulmonary artery rather than the aorta. Most commonly, the anomalous left coronary artery arises from the pulmonary artery in a conditio...



  • Typically presents with paroxysms of poor feeding, pallor, tachypnea, respiratory distress, and diaphoresis

  • Irritability, crying, appearance of being in pain (especially after meals)

  • Ca...


General Measures

The first priority is to safely institute supportive care measures while expeditiously planning for surgical intervention. 

Surgery/Other Procedures

  • Direct reimplantation of th...

Ongoing Care


  • Untreated, 90% of those who present in infancy will die before the age of 1 year, usually at 1 to 2 months of age (when pulmonary vascular resistance falls).

  • Very few of those who...

Additional Reading

  • Azakie  A, Russell  JL, McCrindle  BW, et al. Anatomic repair of anomalous left coronary artery from the pulmonary artery by aortic re-implantation: early survival, patterns of vent...



  • 746.85 Coronary artery anomaly


  • Q24.5 Malformation of coronary vessels


  • 450301003 Anomalous origin of left coronary artery from pulmonary artery (disorder)


  • Q: How do you differentiate crying from the symptoms of myocardial ischemia from crying from colic?

  • A: This is not easy, but clinical assessment should manifest the signs of CHF, shock, and low car...

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