Key result
An 85-year-old woman with anomalous left coronary artery from the pulmonary artery (ALCAPA) survived an aborted sudden death episode and was successfully discharged on medical therapy.
Case Report (n=1)
No
ALCAPA, a congenital anomaly typically fatal in infancy, can rarely present as aborted sudden cardiac death in octogenarians and may be managed medically if surgery is not feasible.
ALCAPA may present as aborted sudden death in octogenarians with medical management feasible; extends phenotypic spectrum but leaves optimal therapy open.
INTRODUCTION: We report a rare coronary anomaly presenting with aborted sudden death in an octogenarian. An anomalous left coronary artery from the pulmonary artery is a rare coronary anomaly which usually presents in the first year of life. Survival into adulthood and the elderly years is extremely rare. CASE PRESENTATION: An 85-year-old Caucasian woman was brought to our hospital following cardiopulmonary arrest. After prolonged resuscitation and stabilization of our patient, further evaluation revealed an anomalous left coronary artery from pulmonary artery syndrome. She was discharged on medication. CONCLUSION: An anomalous left coronary artery from the pulmonary artery can present in elderly and even octogenarian patients. Careful history, physical examination and an appropriate invasive study are needed to confirm the diagnosis.
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Separham et al. (2012) conducted a case report in Anomalous left coronary artery from the pulmonary artery (ALCAPA) (n=1). Medical therapy (acetylsalicylic acid, amiodarone, losartan) was evaluated. An 85-year-old woman with anomalous left coronary artery from the pulmonary artery (ALCAPA) survived an aborted sudden death episode and was successfully discharged on medical therapy.
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