When heart failure reveals itself as bronchiolitis

Georges de Bilderling (1), Claire Geurten (1), Jean Evrard (1), François Kanen (1), Laurent Houtekie (2), Alain Poncelet (3), Karlien Carbonez (4), Stéphane Moniotte (4) Published in the journal : April 2017 Category : Pediatrics

Summary :

A 2-month-old baby is admitted to our unit for bronchiolitis. Due to the infant's prolonged symptoms with predominant feeding difficulties and because of a heart murmur noted on auscultation, cardiac ultrasound is performed, resulting in the diagnosis of ALCAPA syndrome (Anomalous Left Coronary Artery from Pulmonary Artery). ALCAPA is a rare but severe cardiac malformation, with early diagnosis and treatment being key to a good prognosis. Bronchiolitis can provoke heart failure, whereas clinical features of heart failure may mimic bronchiolitis. This clinical case underlines the need for performing a complete clinical examination, along with oriented diagnostic investigations, when confronted with a baby suffering from a respiratory condition whose severity or evolution appears unusual.

Key Words

ALCAPA, coronary malformation, cardiac failure, bronchiolitis, infant

What is already known about the topic?

ALCAPA (Anomalous Left Coronary Artery from Pulmonary Artery) is a rare cardiac malformation characterized by the left coronary artery abnormally originating from the pulmonary artery, contributing to the development of heart failure, usually at a precocious age.

What does this article bring up for us?

The following clinical case emphasizes the relevance of performing a complete clinical examination, when confronted with an infant suffering from any respiratory distress of unusual development, in addition to considering an underlying pathology like heart failure.