Bland-White-Garland syndrome in a neonate

Abstract

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) or the Bland-White-Garland syndrome was first described in the year 1866 and postulated in 1933.  It is an intriguing entity in the field of paediatrics as well as paediatric cardiology due to its varied presentation in the paediatric age group. This congenital heart anomaly is reported in less than 0.5% of all the congenital heart diseases. In the past, infant deaths were frequent due to not diagnosing it promptly. Presently, the prognosis for these patients with ALCAPA has dramatically improved as a result of the scientific advancements in the field of cardiology such as early diagnosis using echocardiography and improvements in cardiovascular surgical techniques. Interestingly many treating doctors are not aware about the significance of the ALCAPA and can be missed easily. The chance of ALCAPA should be searched in every infant or children with non specific symptoms of incessant crying and feeding difficulty to achieve better outcome and to prevent its complication such as sudden death. This case study reports ALCAPA in a 23 day old neonate. Key words: ALCAPA, Bland-White-Garland syndrome, Crying newborn, congenital heart diseases, Coronary steal, Myocardial ischemia, Antero-lateral myocardial infarction