CJO - Abstract - Noninvasive methods of accurately diagnosing in children anomalous origin of the left coronary artery from the pulmonary trunk

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    Noninvasive methods of accurately diagnosing in children anomalous origin of the left coronary artery from the pulmonary trunk
    Kuang-Jen Chien, Ta-Cheng Huang, Kai-Sheng Hsieh, Chu-Chuan Lin, Ken-Pen Weng, Jun-Yen Pan and Cheng-Liang Lee (2009).
    Cardiology in the Young, Volume 19, Issue 05, September 2009 pp 474-481 http://journals.cambridge.org/action/displayAbstract?aid=6372128

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Cardiology in the Young (2009), 19 : 474-481 Cambridge University Press
doi:10.1017/S1047951109990436 (About doi)
Published online by Cambridge University Press 13 Aug 2009
 
Cambridge Journals Online - CUP Full-Text Page
Cardiology in the Young (2009), 19:474-481 Cambridge University Press
Copyright © Cambridge University Press 2009
doi:10.1017/S1047951109990436

Original Article

Noninvasive methods of accurately diagnosing in children anomalous origin of the left coronary artery from the pulmonary trunk

Kuang-Jen Chiena1a2a3a4, Ta-Cheng Huanga1, Kai-Sheng Hsieha1, Chu-Chuan Lina1, Ken-Pen Wenga1, Jun-Yen Pana5 and Cheng-Liang Leea1a3 c1

a1 Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
a2 Department of Pharmacy, Tajen University, Pingtung, Taiwan
a3 Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
a4 Kaohsiung Armed Forces General Hospital
a5 Department of Cardiovascular Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Article author query
chien k PubMed  Google Scholar
huang t PubMed  Google Scholar
hsieh k PubMed  Google Scholar
lin c PubMed  Google Scholar
weng k PubMed  Google Scholar
pan j PubMed  Google Scholar
lee c PubMed  Google Scholar

Abstract

Background Anomalous origin of the left coronary artery from the pulmonary trunk is a rare congenital heart defect. Cardiac catheterization remains the standard means of diagnosis. Our purpose in this study is to emphasize the importance of assessing the electrocardiogram when making the diagnosis, in addition to taking note of transthoracic echocardiographic findings. We also analyzed the sensitivity of each parameter under investigation.

Methods and Results Between June, 1999, and March, 2007, we studied 9 patients, 6 males and 3 females, with a mean age of 3.02 years, in whom anomalous origin of the left coronary artery from the pulmonary trunk was suspected subsequent to transthoracic echocardiographic examination. We examined their electrocardiograms, and undertook cardiac catheterization. In all patients, the transthoracic echocardiogram had shown retrograde flow into the pulmonary trunk, with the left coronary artery arising from pulmonary trunk, along with a dilated right coronary artery, or intercoronary collateral vessels. In 8 patients, the electrocardiogram showed deep Q wave in leads I and aVL, with depression of the ST segments over lead V4 through 6, or inversion of the T waves in leads I, II, and aVL. In the remaining patient, the electrocardiogram showed incomplete right bundle branch block. Later, cardiac catheterization confirmed the diagnosis in 8 patients, but the other patient was shown to have the right coronary artery arising from the pulmonary trunk.

Conclusions By combining transthoracic echocardiography with study of the electrocardiogram, it is possible to provide accurate evaluation of anomalous origin of the left coronary artery from the pulmonary trunk.

(Accepted May 04 2009)

(Online publication August 13 2009)

KeywordsTransthoracic echocardiography; electrocardiogram; idiopathic dilated cardiomyopathy; congestive heart failure; Bland-White-Garland syndrome

Correspondence:

c1 Correspondence to: Dr Cheng-Liang Lee Ph.D., Department of Pediatrics, Kaohsiung Veterans General Hospital, No.386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan. Tel: +886-7-3468203; Fax: 886-7-3599023; E-mail: CLLEEMD2@yahoo.com.tw

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