Anomalous origin of the left coronary artery from the pulmonary artery in infancy with preserved left ventricular function: Potential pitfalls and clues to diagnosis

Left ventricular dysfunction is almost invariably associated with anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) that presents during infancy. We report three cases of infants who presented with ALCAPA with relatively well-preserved left ventricular systolic function with a view to illustrate the mechanisms that help maintain left coronary perfusion and discuss the specific echocardiographic clues that suggest diagnosis in these circumstances.