oa Central African Journal of Medicine - Anomalous origin of the left coronary artery

Volume 8, Issue 8
  • ISSN : 0008-9176



In the congenital anomaly in which the left coronary artery arises from the pulmonary artery instead of the aorta, the majority of cases develop symptoms and signs due to myocardial ischaemia and cardiac failure during the first few months of life. This infantile variety may be recognised clinically by the findings of postprandial distress, cardiac enlargement and an abnormal E.C.C. suggesting cardiac infarction. In a small percentage of cases such symptoms do not develop; the patient may reach adult life and perhaps have a fistulous murmur, but sudden death is an ever-present danger. In view of the grave prognosis, surgical treatment should be considered in all cases where this condition is diagnosed, and consists either of ligation of the aberrant vessel or its transplantation with its ostium into the root of the aorta. The anomaly is discussed with reference to a case of the infantile type that showed complicating endomyocardial fibro-elastosis.

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