Detection of anomalous left coronary artery origin from pulmonary artery in an adult patient presenting with monomorphic ventricular tachycardia

BMJ Case Rep. 2025 Jan 7;18(1):e263308. doi: 10.1136/bcr-2024-263308.

Abstract

A man in his early 50s presented to the emergency department (ED) with sudden onset of palpitation and presyncope. The 12-lead electrocardiogram (ECG) recorded in ED showed monomorphic ventricular tachycardia requiring cardioversion in view of haemodynamic instability. The patient was subsequently detected to have an anomalous left coronary artery origin from the pulmonary artery. We present the features of this case that lead to clinical suspicion of this disease and discuss the presentation of anomalous left coronary artery origin from the pulmonary artery (ALCAPA) in adults.

Keywords: Arrhythmias; Cardiovascular medicine; Pacing and electrophysiology.

Publication types

  • Case Reports

MeSH terms

  • Anomalous Left Coronary Artery / complications
  • Anomalous Left Coronary Artery / diagnosis
  • Coronary Angiography
  • Coronary Vessel Anomalies / complications
  • Coronary Vessel Anomalies / diagnosis
  • Electrocardiography*
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Artery* / abnormalities
  • Pulmonary Artery* / diagnostic imaging
  • Tachycardia, Ventricular* / diagnosis