Bland-White-Garland Syndrome in an 8-Year-Old Child

The anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) or Bland- White-Garland syndrome is a rare congenital lesion. It is the most common congenital coronary artery anomaly (0.26% of patients with congenital heart disease) that results in myocardial ischemia and infarction in children.1 ALCAPA usually presents in infancy when the pulmonary vascular resistance drops in the first few weeks of life.2 Depending on the degree of collateral development, myocardial ischemia or infarction may occur. Since 90% of such patients die during the first year of life,3 ALCAPA is rarely seen and reported in children (Iranian Heart Journal 2007; 8 (4): 69-71).