Respiratory Viral Infection Unmasking Congenital Heart Disease.

Congenital heart disease affects nearly 1% of all live births or 40,000 infants each year. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect that constitutes 0.25% to 0.50% of all congenital cardiac diseases. If left untreated, infant mortality is as high as 90%. The following is a case report of a 4-month-old infant presenting with respiratory viral illness and a chest radiograph demonstrating cardiomegaly. Echocardiography revealed possible ALCAPA with severe left ventricular (LV) dysfunction. The diagnosis was confirmed using gated computed tomography angiography (CTA). The patient required urgent surgical correction and post-operative circulatory support for myocardial rest in the setting of severe left ventricular dysfunction.