Bland-White-Garland syndrome in an asymptomatic adult individual: the role of imaging diagnostics in establishing a definitive diagnosis and preventing severe cardiac complications

Bland-White-Garland syndrome otherwise known as anomalous left coronary artery from the pulmonary artery is classified as a rare congenital heart defect which can be fatal, if unrecognized and untreated. In most cases, the disease occurs in the neonatal age, while a small percentage of patients remain asymptomatic or sparsely symptomatic for many years, making early diagnosis and treatment difficult and delayed. In the following paper, we present a case of a 39-year-old Caucasian woman with no past medical history or systematic cardiac treatment who was admitted to the cardiology clinic with escalating symptoms of heart failure. Laboratory tests revealed an increase in NT-proBNP without elevation of the myocardial necrosis markers. Echocardiography showed generalized wall hypokinesis, left ventricular enlargement with features of hypertrophy, and additional flow in the pulmonary trunk. The patient was referred for further imaging examination to make a definite diagnosis, with a suspicion of patent ductus arteriosus.