ORIGIN OF THE LEFT CORONARY ARTERY FROM THE PULMONARY ARTERY

Abstract

THE LEFT coronary artery arising from the pulmonary artery represents a rare anomaly which until 1933 was not diagnosed clinically.¹Abrikosoff²reported the first case in 1911. In 1946 Kaunitz³found 27 cases in the literature and added 2 of his own. In 1949 Gasul and Loeffler⁴collected 22 cases in the literature and reported 4 additional cases. Since then four more cases have been described.⁵ Patients with this anomaly usually do not survive the first year of life, although a few have lived to adulthood. In infancy a distinctive picture may be recognized. It is characterized by progressive dyspnea, apparent pain and symptoms of shock after feeding, and progressive cardiac enlargement and failure. Cyanosis, clubbing, cardiac murmurs, and thrills are absent. The electrocardiogram shows inversion of T waves, usually in all three limb leads, and low voltage. Roentgenograms and fluoroscopy reveal conspicuous cardiac enlargement,