The Bland-White-Garland Syndrome (BWGS) involves the anomalous origin of the left coronary artery from the pulmonary artery. Surgery can be life-saving.
Synonym: Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA)
The primary finding is the anomalous connection between the pulmonary artery and the left coronary artery.
(1) The left coronary artery may be dilated and tortuous.
(2) Anomalous connections with the right coronary artery may be present.
(3) Coronary steal from the left coronary artery into the pulmonary artery.
The syndrome often presents during infancy but may not present until adulthood.
In infants the patient may have:
(1) dyspnea
(2) pallor
(3) difficulty feeding
(4) failure to thrive
(5) sudden death
An older patient may have:
(1) exertional chest pain
(2) dyspnea
There may be evidence of a left-sided myocardial infarction on ECG.
Imaging of the coronary arteries is diagnostic (angiography, echocardiography, etc).
Surgery may be performed to correct problems in the delivery of blood to the coronary arteries.
