Atypical presentation of anomalous origin of the left main coronary artery from the pulmonary artery.

Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that usually presents in childhood. Ninety percent of the patients with ALCAPA die within the first year of life without surgical intervention. In adults, ALCAPA is associated with left ventricular dysfunction, mitral regurgitation, and sudden death. The present report describes the case of an adult patient who presented with an abnormal stress test and ALCAPA was diagnosed during cardiac catheterization.