Anomalous origin of Left Coronary Artery from Pulmonary Artery (ALCAPA) is a rare congenital anomaly. Its survival into adulthood is further rare. Clinical manifestations result from evolving morphological - functional alterations in pulmonary circulation that occur after the birth. We report a case of 43 year old adult patient with effort angina and without any ECG or Echo abnormalities. On coronary angiography, typical anatomy of ALCAPA was revealed.
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