Undiagnosed ALCAPA presentation at the preoperative anesthesia clinic

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly first described in 1908 and has an incidence of 0.26% of all cases of congenital heart diseases. Nearly 90% of patients die within one year if left untreated; however, a few patients can survive into adulthood. This depends on the inflow of blood to the left coronary artery (LCA) via collaterals from the right coronary artery (RCA). We report a case of a 45-year-old woman referred to the preoperative anesthesia clinic in April 2017 for a laparoscopic hysterectomy under general anesthesia.