ALADAPA Syndrome: An Insidious Trigger for Fatal Acute Coronary Syndrome Following Oral Contraceptive Overdose
Abstract
The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly associated with a high risk of adverse cardiac events and mortality. The isolated origin of the left anterior descending artery from the pulmonary artery (ALADAPA) is even more infrequent. Although the clinical course is generally quieter than the classic ALCAPA syndrome, it carries a high risk of sudden cardiac death. Conditions that predispose individuals to thrombogenicity can precipitate this insidious condition. In this case report, we describe a fatal instance of ALADAPA syndrome, diagnosed for the first time post-cardiac arrest in a young woman following the use of high-dose oral contraceptive pills for emergency contraception.
Keywords
References
- Krexi L, Sheppard MN. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), a forgotten congenital cause of sudden death in the adult. Cardiovasc Pathol. 2013;22(4):294-7. doi:10.1016/j.carpath.2012.11.006.
- Villa AD, Sammut E, Nair A, Rajani R, Bonamini R, Chiribiri A. Coronary artery anomalies overview: the normal and the abnormal. World J Radiol. 2016;8(6):537-55. doi:10.4329/wjr.v8.i6.537.
- Pachon R, Bravo C, Niemiera M. Sudden cardiac death as a presentation of anomalous origin of the left coronary artery from pulmonary artery in a young adult. Eur Heart J Acute Cardiovasc Care. 2015;4(6):589-90. doi:10.1177/2048872614562969.
- Frescura C, Basso C, Thiene G, Corrado D, Pennelli T, Angelini A, et al. Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol. 1998;29(7):689-95. doi:10.1016/s0046-8177(98)90277-5.
- Roach RE, Helmerhorst FM, Lijfering WM, Stijnen T, Algra A, Dekkers OM. Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke. Cochrane Database Syst Rev. 2015;2015(8):CD011054. doi:10.1002/14651858.CD011054.pub2.
- Ismail MY, Nassar MI, Hamad MA. Anomalous left anterior descending coronary artery arising from pulmonary artery in a 63 year-old male patient: case report and literature review. Heart Views. 2015;16(3):98-103. doi:10.4103/1995-705X.164461.
- Quah JX, Hofmeyr L, Haqqani H, Clarke A, Rahman A, Pohlner P, et al. The management of the older adult patient with anomalous left coronary artery from the pulmonary artery syndrome: a presentation of two cases and review of the literature. Congenit Heart Dis. 2014;9(6):E185-94. doi:10.1111/chd.12125.
- Dionne PO, Poirier N, Forcillo J, Stevens LM, Chartrand-Lefebvre C, Mansour S, et al. A rare case of anomalous origin of the left main coronary artery in an adult patient. J Cardiothorac Surg. 2013;8:15. doi:10.1186/1749-8090-8-15.
Details
Primary Language
English
Subjects
Cardiology
Journal Section
Case Report
Publication Date
August 21, 2026
Submission Date
February 14, 2026
Acceptance Date
July 2, 2026
Published in Issue
Year 2026 Volume: 28 Number: 2
