Angina Pectoris as a Manifestation of ALCAPA Syndrome in a 20-Year-Old Female: A Case Report and Review of Literature

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is considered a rare congenital heart disease where the take-off of the left coronary artery abnormally originates from the pulmonary artery instead of left aortic sinus. It is associated with a high mortality rate in the first year of life and sudden death in adults if left untreated. We report an adult form of ALCAPA syndrome in a 20-year-old female who presented with anginal pain for the previous few months. Unfortunately, the patient was hesitant to have surgery at the time. LEARNING POINTS: The abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare and potentially fatal coronary congenital disease, accounting for 0.5% of all congenital heart diseases; it is associated with poor outcomes if left untreated. ALCAPA is classified into infantile and adult forms. The prevalence of adult individuals with ALCAPA syndrome has significantly increased as a result of recent developments in non-invasive cardiac imaging. The prevalence of sudden mortality in childhood and the early stages of adulthood makes surgery the preferred treatment, and coronary reimplantation surgery is considered the surgical procedure of choice.