Case Report: a 28-year-old female with anomalous origin of the left coronary artery from the pulmonary artery syndrome presented as atrial fibrillation and pulmonary hypertension.

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) typically manifests in the first weeks of life. We report a 28-year-old woman with atrial fibrillation and pulmonary hypertension which were later found to be associated with ALCAPA syndrome. Despite a history free of traditional cardiovascular risk factors, her symptoms included exercise intolerance, palpitations, and an ischemic stroke. Echocardiography and further examination revealed pulmonary artery origin of the left coronary artery and extensive collateral formation between the left and right coronary arteries, contributing to her symptoms.