How are dilated cardiomyopathy and myocarditis differentiated from anomalous left coronary artery from the pulmonary artery (ALCAPA)?

Updated: Aug 10, 2020
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Syamasundar Rao Patnana, MD  more...
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The most serious, yet avoidable, complication is the mistaking of symptoms in the patient older than several months who presents with anomalous left coronary artery from the pulmonary artery (ALCAPA) as idiopathic dilated cardiomyopathy [9, 10] or end stage myocarditis. [9] The initial presentation may be entirely similar but the treatments are dramatically different. The clinical and initial laboratory findings may be remarkably similar. If there is significant pulmonary artery hypertension, the diagnostic electrocardiographic (ECG) findings may not be apparent. Careful definition of the origin of the coronary arteries by echo-Doppler ultrasonographic studies in every patient presenting with the above clinical scenario should be undertaken. Selective cine-aortography to evaluate the origin of coronary arteries is no longer routinely necessary because of the usefulness of echocardiographic studies.

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