J Korean Soc Echocardiogr.  1994 Jul;2(1):96-103. 10.4250/jkse.1994.2.1.96.

A Case of Bland-White-Garland Syndrome

• Lee S
• Sohn JW
• Yoon SN
• Lee JU
• Kim CS
• Kim JH
• Lim HK
• Lee BH
• Lee CK

• KMID: 2410465
• DOI: http://doi.org/10.4250/jkse.1994.2.1.96

Abstract

The congenital anomalous origin of the left coronary artery arising from the pulmonary artery, or the Bland-White-Garland syndrome, is uncommon but frequently lethal lesion of both children and adults. In several series, it has a frequency of 0.26-0.46% of all congenital cardiac defects. The mortality rate among infants and children without operation has been eighty to ninety percent. Survival to teen-age and adult has been infrequent ; review of the literature regarding this anomaly in Korean disclosed only 3 cases in infants and children and 2 cases in adults. In a 45-year-old male with palpitation and effort angina, the anomalous origin of the left coronary artery from the pulmonary artery was diagnosed by echocardiogram and coronary arteriography.

MeSH Terms

Adult
Angiography
Bland White Garland Syndrome*
Child
Coronary Vessels
Humans
Infant
Male
Middle Aged
Mortality
Pulmonary Artery

Figure

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  Fig. 1. Electrocardiography shows atrial fibrillation and ST change in lead I. aVL.

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  Fig. 2. Chest X ray shows cardiomegaly.

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  Fig. 3. Treadmil test; (a) resting, (b) shows ST change in Bruce protocol stage II.

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  Fig. 4. Short axis view at base; anomalous origin of left coronary artery from pulmonary artery(RVOT: right ventricular outflow tract. AO: aorta. FV: pulmonary valve).

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  Fig. 5. Short axis view.at base; Color Doppler shows reversed flow from left coronary artery to pulmonary artery(RVOT: right ventricular outflow tract. AO: aorta. PV: pulmonary valve. Arrow: toward flow)

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  Fig. 6. Short axis view at base; Enlarged right coronary artery(RVOT: right ventricular outflow tract, AO: aorta, LA: left atrium).

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  Fig. 7. Parasternal long axis view; Color Doppler showing diastolic flow in right coronary artery(Arrow; toward flow).

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  Fig. 8. Parasternal long axis view. Large right coronary artery(RV: right ventricle. LV: left ventricle, AO: aorta. AOV: aortic valve. LA: left atrium.

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  Fig. 9. Right coronary angiogram in shallow LAO view; enlarged, tortous coronary A.

Reference

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