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Published online: 2024-05-13

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Bland-White-Garland syndrome in an asymptomatic adult individual: the role of imaging diagnostics in establishing a definitive diagnosis and preventing severe cardiac complications.

Azita Rezaei1, Marcin Gregorczyk2, Piotr Jagodowski3, Łukasz Marek Gawlik4, Łukasz Wypchło5, Ewa Stochmal5, Jan Spałek6, Beata Wożakowska-Kapłon57, Michał Spałek58

Abstract

Bland White' and Garland syndrome otherwise known as ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) is classified as a rare congenital heart defect, which if unrecognized and untreated can be fatal. In most cases, the disease makes itself known in neonatal age, while a small percentage of patients, on the other hand, remain asymptomatic or sparsely symptomatic for many years, thus hindering and delaying early diagnosis and therapeutic measures. In the following paper, we present a 39-year-old Caucasian woman with no past medical history or systematic cardiac treatment who was admitted to the cardiology clinic with worsening symptoms of heart failure. Laboratory tests showed an increase in NT-proBNP and no increase in myocardial necrosis index. Echocardiography showed generalized wall hypokinesis, left ventricular enlargement with features of hypertrophy, and additional pulmonary trunk flow. The patient was referred for further imaging studies to make a confident diagnosis, with a suspicion of PDA (Patent Ductus Arteriosus).

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