Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA)

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), is also known as the Bland-White-Garland Syndrome. It is a rare congenital heart lesion mostly seen in infants aged one and rarely seen in adults. A 60 year old female, suffered from chest tightness, shortness of breath, dizziness, palpitations, discomfort accompanied by light headiness especially during walking for a short distance, whilst walking upstairs starting in  late February . She had no history of diabetes or hypertension. An Electrocardiogram showed atrial fibrillation and left ventricular hypertrophy.  Echocardiography revealed LVD 61mm, LA 41mm, EF 63%, possible coronary pulmonary artery fistula, moderate aortic regurgitation, mild mitral regurgitation and for further treatment she was sent to our hospital. She was advised to undergo multi detector computed tomography examination (MDCT) and was diagnosed with ALCAPA and she was scheduled for a surgery.