Anomalous left coronary artery from pulmonary artery revealed by acute bronchiolitis

Despite its common occurrence bronchiolitis can reveal many disorders such as malformations or immunological diseases. We report a rare and serious cause of bronchiolitis in the newborn: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Case report. - A four-month-old infant was admitted with hypoxic bronchiolitis. Congenital heart disease was suspected in view of the severity of symptoms and the association of poor weight gain and cardiomegaly. Transthoracic Doppler echocardiography performed by an experienced team and coronary multislice spiral computed tomography led to the diagnosis of a left coronary artery arising from the proximal left side of the pulmonary artery trunk. Discussion. - ALCAPA is a rare congenital anomaly that can be revealed by intercurrent infection such as bronchiolitis in infancy. Only early diagnosis and surgery to restore a system with two normally arising coronary arteries can produce a satisfactory outcome, possibly leading to progressive myocardial recovery. (c) 2012 SPLF. Published by Elsevier Masson SAS. All rights reserved.