A Wrong Turn

This clinical case describes a 21 year old postpartum woman with sickle cell trait who presented with abdominal pain, dyspnea, and left arm weakness following a complicated cesarean delivery. Initial evaluations suggested volume overload and heart failure, but multimodal imaging revealed an anomalous left coronary artery from the pulmonary artery (ALCAPA), a rare congenital defect typically diagnosed in infancy. The patient’s symptoms were exacerbated by peripartum hemodynamic stress, highlighting the importance of considering congenital heart disease in postpartum cardiomyopathy. Surgical correction was successfully performed, restoring normal cardiac function.

This clinical case describes a 21 year old postpartum woman with sickle cell trait who presented with abdominal pain, dyspnea, and left arm weakness following a complicated cesarean delivery. Initial evaluations suggested volume overload and heart failure, but multimodal imaging revealed an anomalous left coronary artery from the pulmonary artery (ALCAPA), a rare congenital defect typically diagnosed in infancy. The patient’s symptoms were exacerbated by peripartum hemodynamic stress, highlighting the importance of considering congenital heart disease in postpartum cardiomyopathy. Surgical correction was successfully performed, restoring normal cardiac function.