Kadir BABAOĞLU, Levent SALTIK, Gürkan ÇETİN, Gürkan ALTUN, Köksal BİNNETOĞLU

Yenidoğan döneminde dilate kardiyomiyopatinin nadir bir nedeni: ALCAPA sendromu

Sol koroner arterin pulmoner arterden çıkış anomalisi olarak tanımlanan ALCAPA sendromunda kardiyomegali, kalp yetersizliği gibi yakınma ve bulgular genellikle yaşamın ikinci-üçüncü ayları sonrasında ortaya çıkar. Yenidoğan döneminde ise hastalar genellikle yakınmasız olup, bu dönemde tanı alan hasta sayısı oldukça azdır. Burada yenidoğan döneminde kalp yetersizliği tablosunda kliniğimize başvuran, elektrokardiyografisinde DI ve aVL’de derin ve geniş Q dalgaları, ve ST yüksekliği gibi miyokard iskemi bulguları bulunan bir olgu sunuldu. Ekokardiyografik incelemede dilate kardiyomiyopati ile birlikte sol koroner arterin pulmoner arterden çıktığı izleniminin alınması nedeniyle yapılan kalp kateterizasyonu ve anjiyografi ile tanı kesinleşti. Bu olgunun sunulması ile ALCAPA sendromunun yenidoğan döneminde bile dilate kardiyomiyopatiye yol açarak bulgu verebileceği vurgulanmak istenmiş ve bu hastalığa olan farkındalığı artırmak amacı güdülmüştür. (Türk Ped Arfl 2011; 46: 256-8)

A rare cause of dilated cardiomyopathy in the newborn period: ALCAPA syndrome

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect. ALCAPA is asymptomatic in many cases in newborn periode. It is mostly diagnosed in the first few months. In this case report, we present a newborn with ALCAPA who admitted to our clinic with heart failure occurred at an earlier age than expected. The electrocardiography showed deep wide Q waves in D1 and aVL, ST elevation in leads V1-V6. Echocardiography revealed a dilated cardiomyopathy and left main coronary artery originates from pulmonary artery. Diagnosis was confirmed by coronary angiography. In this report, we emphasized that ALCAPA may cause dilated cardiomyopathy also in newborn period and we aimed that enhanced awareness of this disease. (Turk Arch Ped 2011; 46: 256-8)

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