Anomalous left coronary artery from the pulmonary artery (ALCAPA)


ALCAPA can present in two ways: 

  • infantile - no collaterals, RCA and LAD are normal caliber. This can lead to ischemic cardiomyopathy secondary to infarction
  • adult - retrograde flow collaterals from RCA to LAD with dilatation from increased flow. This can lead to chronic myocardial ischemia, arrhythmia and sudden death