PMC7721445_01
12-lead surface electrocardiogram depicting sinus rhythm, left ventricular hypertrophy with intraventricular conduction defect, left axis deviation and secondary repolarization abnormalities.
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C-reactive protein were normal. 12-lead electrocardiogram showed left ventricular hypertrophy and secondary repolarization abnormalities (Fig. 1). Cardiac ultrasound (GE Vivid I Ultrasound Machine) revealed diffusely hypokinetic left ventricular with ejection fraction of 40-45% and mild mitral regurgitation.
Axial Coronary CT-angiography image showing an anomalous origin of the left main coronary artery from the pulmonary artery (PA).
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EKG-gated MD-CCTA (Siemens Definition Flash, Siemens Healthineers, Erlangen, Germany), discovered ALCAPA (Fig. 2) but normal origin of the RCA from the right aortic coronary sinus (Fig. 3).