Abstract
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare congenital condition which can manifest as various cardiac symptoms. CASE REPORT: A 66-year-old woman who presented for pre-operative surgical risk assessment for hip surgery underwent a nuclear stress test which revealed a large reversible anterior defect. At coronary angiography she was found to have ALCAPA. CONCLUSIONS: This is a rare case of ALCAPA due to the patient's age. Survival to adulthood is possible and patients may remain relatively asymptomatic for years..