Anomalous Left Coronary Artery Arising from the Pulmonary Artery (ALCAPA): The Critically Important Role of Color Flow Doppler in Identifying a Rare Intramural Course

Mar 10, 2022 | CASE

Anomalous left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly that can present with congestive heart failure and ischemic mitral regurgitation in an infant. Coronary imaging by echocardiography in the pediatric population is difficult due to small vessel size, high heart rate, and patient cooperation. This case presents an additional challenge in diagnosis due to a rare variant of ALCAPA with an intramural aortic course that leads to the false impression of normal left coronary origin.