Anomalous origin of left coronary artery from right pulmonary artery in an infant with coarctation of the aorta Anil Sivadasan Radha, DNB, Baiju Sasi.

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Anomalous origin of left coronary artery from right pulmonary artery in an infant with coarctation of the aorta Anil Sivadasan Radha, DNB, Baiju Sasi Dharan, MCh, Raman Krishna Kumar, DM, Suresh Gururaja Rao, MCh The Annals of Thoracic Surgery Volume 78, Issue 1, Pages 324-326 (July 2004) DOI: 10.1016/S0003-4975(03)01469-3

Fig 1 Parasternal short axis view on echocardiography shows that (arrow) the LMCA seems to arise from the AO in the normal fashion. (AO = aorta; LAD = left anterior descending artery; LMCA = left main coronary artery; PA = pulmonary artery.) The Annals of Thoracic Surgery 2004 78, 324-326DOI: (10.1016/S0003-4975(03)01469-3)

Fig 2 (A) Color Doppler showing retrograde flows in LAD and LCX. Note the blue flow in LAD (normal flow is red). (B) Color Doppler showing apparently normal flows in LAD and LCX. This pattern of flow was seen when there was significant acidosis and hypercarbia. (AO = aorta; LAD = left anterior descending artery; LCX = left circumflex artery; PA = pulmonary artery.) The Annals of Thoracic Surgery 2004 78, 324-326DOI: (10.1016/S0003-4975(03)01469-3)

Fig 3 (A) 12 lead ECG showing ST depression and T wave inversion in V1 to V6. ST elevation is also obvious in inferior leads. (B) ST depression and T wave inversion is seen to be normalized. This was consistently observed during periods of respiratory acidosis. This ECG was taken when echocardiography showed antegrade flows in LCA. (ECG = electrocardiogram; LCA = left coronary artery; ST = segment elevations.) The Annals of Thoracic Surgery 2004 78, 324-326DOI: (10.1016/S0003-4975(03)01469-3)