Abstract

Therapeutic decision in adult patient with Bland-White-Garland Syndrome (ALCAPA)

Author(s): Thomas C Assmann, Raphael Chiarini, David B Mattos, Leandro AF Nascimento, Marcos CV de Almeida,Januario M de Souza and Decio Salvadori Junior

The present study reports the case of a 32-year-old-female patient, born in the city of Sao Paulo, Brazil, that underwent coronary angiography to investigate exercise intolerance and palpitations with positive test for myocardial ischemia in hemodynamics service in Real e Benemérita Associaçao Portuguesa de Beneficencia Sao Paulo-Sao Joaquim Hospital. During the hemodynamic examination she was diagnosed with Syndrome Bland-White-Garland, a rare congenital defect, estimating its incidence at 1: 300,000 live births. It was chosen to hospitalization for complementary tests and therapeutic decision. After detailed study of the case, we followed-up the patient with conservative treatment for 5 months with partial improvement of symptoms, but with myocardial scintigraphy showing drug induced ischemia, large to moderate extension, we indicated the surgical treatment. After 3 months, patient was asymptomatic with scintigraphy showing discreet extension of ischemia.