Anomalous origin of the left coronary artery from pulmonary artery misdiagnosed as postpartum cardiomyopathy.

A 30-year-old woman with a history of presumed postpartum cardiomyopathy presented to her primary care physician's office with crescendo angina and shortness of breath. She was found to be in supraventricular tachycardia, managed with the Valsalva maneuver, and was discharged home without any further workup. She again presented with exertional symptoms. Her electrocardiogram revealed abnormal T waves and her stress test was strongly positive. Cardiac catheterization revealed an absent left coronary ostium and a dilated right coronary artery, with large collaterals supplying the left coronary system; coronary computerized tomography revealed the anomalous origin of the left main coronary artery arising from the posterolateral aspect of the pulmonary artery, highly suggestive of the anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) anomaly (Bland-White-Garland anomaly).