ABSTRACT
Objective: To explore the pathogenesis, clinical characteristics, diagnosis and treatment methods of anomalous origin of left coronary artery from pulmonary artery (A L C A P A), and to improve the clinicians'understanding of the disease. Methods: The clinical data of an adult patient with ALCAPA who had been misdiagnosed as endocardial fiborelastosis (E F E) were retrospectively analyzed; in the meanwhile, the related literatures were reviewed. Results: The patient admitted to hospital because of her intermittent precordial pain, chest tightness and shortness of breath, and suffered from more than 2 months, aggravated for 3 d. The patient was preliminarily diagnosed as cardiomyopathy (considering the great possibility of E F E), atrial fibrillation, N Y H A E. After treatment, paroxysmal retrosternal pain still occurred, and ventricular fibrillation occurred one time. Finally, the patient was diagnosed as ALCAPA by coronary artery CTA, and treated by coronary artery bypass grafting. After operation, the patient recovered well. Conclusion: ALCAPA is relatively rare, and its clinical manifestations lack specificity, so it is easy to misdiagnose. Coronary artery CTA is an effective diagnostic method, and operation is the first choice for its treatment.