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• W4387474269 abstract "Introduction Bland White Garland Syndrome is a rare disease characterised by an anomalous origin of the left coronary artery from the pulmonary trunk (ALCAPA) (1). It affects 1 in 300,000 live births (2). Onset of symptoms is usually observed in the neonatal period, however, cases of asymptomatic adult patients have also been reported (1). Methods A 29 year old female was brought in by ambulance to the emergency department following an out of hospital cardiac arrest (OOHCA). She had a witnessed collapse in the community with immediate bystander CPR. Upon arrival of the paramedics, she was in ventricular fibrillation and, after receiving one shock, return of spontaneous circulation (ROSC) was achieved. She had a background of DiGeorge syndrome, mosaic trisomy 14, Pierre Robin sequence, recurrent aspiration pneumonias and was noted to have had a previous cardiac arrest on induction of anaesthesia as a child. On arrival to the emergency department, her Glasgow Coma Scale was 3 and she was subsequently intubated. CT-pulmonary angiogram and CT-brain demonstrated no abnormalities. She was admitted to ICU and commenced on intravenous antibiotics for pneumonia. Following an uncomplicated course in ICU, she was extubated on day 2. An ECHO performed during her admission demonstrated moderate dilation of her left ventricle (LV) and moderate dysfunction of her LV with an ejection fraction of 35-40%. Results She was transferred to the Mater hospital where a cardiac MRI showed signs of subendocardial infarction involving the high and low anterolateral segments extending through greater than 50% of the myocardial wall. A subsequent CT cardiac angiogram diagnosed anomalous left coronary artery from the pulmonary artery with collateral supply to this artery from the right coronary and from the hypertrophied bronchial artery. She had a pacemaker inserted and subsequently underwent reimplantation to establish a dual coronary system. Discussion ALCAPA syndrome is a rare cause of cardiac arrest. Although typically diagnosed in early childhood, there are case reports of ALCAPA syndrome presenting with cardiac arrest in previously well adult patients. The development of inter-coronary collateral vessels from the right coronary artery can allow survival into adulthood without symptoms developing (3). In those who are diagnosed in adulthood, mitral regurgitation is often the first symptom, however, as in this case, it can often present with an unexplained cardiac arrest (3)." @default.
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• W4387474269 date "2023-10-01" @default.
• W4387474269 modified "2023-10-16" @default.
• W4387474269 title "Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) as a cause of an Out Of Hospital Cardiac Arrest" @default.
• W4387474269 doi "https://doi.org/10.1053/j.jvca.2023.08.121" @default.
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