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Pediatr Cardiol. 2013 Mar;34(3):489-91. doi: 10.1007/s00246-012-0599-7. Epub 2012 Dec 15.

Electrocardiogram of anomalous left coronary artery from the pulmonary artery in infants.

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  • 1Department of Pediatrics and Cardiovascular Research Institute, University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA.


The electrocardiogram of an infant with anomalous left coronary artery from the pulmonary artery (ALCAPA, Bland-White-Garland syndrome) usually shows typical signs of an anterolateral myocardial infarction, manifested by abnormal Q waves in leads I, avL, V5, and V6, as well as by transient ST changes in these leads. Because 20-45% of such patients do not show abnormal Q waves, the diagnosis should be strongly suspected if there is an abnormal R wave progression in the chest leads.

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