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Congenital coronary artery anomalies are rare and represent 0.24-0.46% of all congenital heart defects. The most common is an anomaly in which the left coronary artery arises from the pulmonary artery (ALCAPA), also known as a Bland-White-Garland syndrome. Nonspecific symptoms typically appear at 2-3 months of age. We present the case of a 10-week-old boy admitted to the hospital due to cough and dyspnea, with suspicion of a respiratory tract infection with no clinical improvement after standard therapy. The chest X-ray revealed cardiomegaly. The electrocardiogram showed signs of anterolateral infarction. Echocardiography revealed signs of dilatated cardiomyopathy and color Doppler was of great value in establishing a final diagnosis. After confirming the diagnosis of ALCAPA in computed tomography angiography, the patient was operated on, with a good outcome. [ABSTRACT FROM AUTHOR]

Cardiomyopathies have a low prevalence in children and thus may lead to malignant ventricular arrhythmias or the progression of heart failure, resulting in death. In adults, the QRS-T angle derived from ECG has been associated with adverse outcomes in patients with hypertrophic and dilated cardiomyopathies. We aimed to assess the electrocardiographic parameters, including QRS-T angle, associated with adverse cardiac events in children with cardiomyopathies. Forty-two children with cardiomyopathies were included in this study: 19 with dilated cardiomyopathy, 17 with hypertrophic cardiomyopathy, and 6 with left ventricular non-compaction. Additionally, 19 control subjects were recruited. In terms of ECG parameters, the QRS-T angle was significantly greater among patients with adverse outcomes compared to patients without the end points of the study (133° vs. 65°, p < 0.001). On Kaplan–Meier survival curves, QRS-T angle > 120°, increased serum concentrations of NT-proBNP and troponin I levels as well as greater NYHA or Ross scale were associated with the greatest risk of unfavorable outcome. The QRS-T angle appears to be a valuable component of 12-lead ECG interpretation, and might be helpful in outlining patients with the greatest cardiovascular risk. Additionally, serum biomarkers such as NT-proBNP (p = 0.003) and troponin (p < 0.001) are useful in outlining patients with the worst survival. [ABSTRACT FROM AUTHOR]

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