Adult type anomalous origin of the left coronary artery from the pulmonary artery: when should we be aware?

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a clinical entity characterized by myocardial ischemia which becomes symptomatic shortly after birth leading to left heart failure and death. It is rare for an ALCAPA patient to survive to adulthood. In this case, the diagnosis is sometimes missed because of atypical clinical presentation or of the unawareness of doctors. Here, we report a case of an 11-year-old boy with ALCAPA syndrome whose diagnosis took many years to be set-up.