Abstract

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare congenital cardiac anomaly which results high mortality during infantile period and only 10% to 15% of the individuals with this defect reach adulthood. We describe a 60 year-old women case with ALCAPA who was misdiagnosed with LM occlusion that lead to unnecessary coronary artery bypass grafting (CABG). After surgery a patient’s symptoms deteriorated until visit at our clinic definitive diagnosis was not estabilished. This clinical case highlights the importance of recognizing the risks of misdiagnosis, which can lead to life-threatening conditions. Invasive coronary angiography (ICA) was the standard for ALCAPA diagnosis as it depicted the course of the anomalous coronary artery; however, it has been largely replaced by noninvasive diagnostic testing. Thorough examination is essential, particularly when atypical alterations in the vascular bed are identified.