Abnormal Origin of the Left Coronary Artery From the Pulmonary Artery Discovered at Age 67: What to Do?

Anomalous left coronary artery from the pulmonary artery (ALCAPA) was described by Abbott in 1908. In most cases, it is an isolated lesion, being the most common cause of myocardial ischemia in children. The associated mortality rate without intervention reaches 90% during childhood. We report the case of a 67-year-old woman, who underwent coronary angiography for investigation of atypical chest pain and was found to have ALCAPA. The patient refused surgery and has remained asymptomatic on a medical regimen.