Anomalous Left Coronary Artery from the Pulmonary Artery—Child



Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare heart defect.

Normally, the left coronary artery carries oxygen-rich blood to the heart muscle. The oxygenated blood comes from the aorta.

With ALCAPA, the left coronary artery is not connected to the aorta. Instead, it is connected to the pulmonary artery. This means that the blood does not have enough oxygen in it from the lungs. With this defect, the heart muscles get blood that is low in oxygen. The blood also leaks back into the pulmonary artery because of the low pressure in it.

The Coronary Arteries

si1902_the coronary arteries
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ALCAPA is a congenital defect. This means that the baby is born with it. It is not known why this happens.

Risk Factors

Risk factors for this problem are not known.


Problems may be:

  • Rapid breathing
  • Poor feeding
  • Slow growth
  • Sweating
  • Irritability
  • Swelling around the eyes and feet


ALCAPA may be found at birth. In others, it may not be found until the baby is 2 to 6 months of age.

The doctor will ask about your child’s symptoms and health history. A physical exam will be done.

Images may be taken of your child's body. This can be done with:

Your child's heart function may be tested. This can be done with:


Surgery will be needed to help with heart function and blood flow. The left coronary artery will be:

  • Detached from the pulmonary artery
  • Reconnected to the aorta

Lifelong heart monitoring will be needed.


There are no known guidelines to prevent this health problem.


American Heart Association
Family Doctor—American Academy of Family Physicians


Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada


Anomalous coronary arteries. EBSCO DynaMed website. Available at: Accessed March 10, 2021.
Anomalous left coronary artery. Cove Point Foundation, Johns Hopkins University website. Available at:
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Accessed March 10, 2021.
Anomalous left coronary artery from the pulmonary artery (ALCAPA). Boston Children's Hospital website. Available at:
...(Click grey area to select URL)
Accessed March 10, 2021.
Anomalous left coronary artery from the pulmonary artery (ALCAPA). The Children's Hospital of Philadelphia website. Available at:
...(Click grey area to select URL)
Accessed March 10, 2021.
Villa AD, Sammut E, et al. Coronary artery anomalies overview: The normal and the abnormal. World J Radiol. 2016 Jun 28;8(6):537-555.
Last reviewed December 2020 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 3/10/2021

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