Asymptomatic Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) in an Adult

Author(s): Demetrio Sharp Dimitri, Patrick Albertus, Muhammad Khan, Andrew Panakos, Carlos E Alfonso, Vicente Orozco-Sevilla

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is considered a rare and very fatal congenital coronary artery anomaly. It is estimated that this congenital abnormality affects 1 of every 300,000 live births and accounts for 0.25% of all congenital heart defects worldwide. ALCAPA manifests itself most commonly in infant population and it has a 1-year mortality rate of approximately 90%, therefore it is not often considered a diagnosis in the adult population [1,2]. When it presents in adult it is considered an important cause of sudden cardiac death [3,4]. We describe a patient in whom this anomaly was diagnosed during cardiac catheterization for evaluation of progressive shortness of breath and mild to moderate mitral regurgitation founded on a transthoracic echocardiogram [5].