Anomalous origin of coronary artery from the pulmonary artery Anomalous origin of left coronary artery from the pulmonary artery 2012-04-09T08:40:53Z Bland-Garland-White syndrome UMLS:C3472166 Left main coronary artery begins (branches off from) the pulmonary artery rather than as normal from the root of the aorta, above the left cusp of the aortic valve. ALCAPA HP:0011638 Anomalous left coronary artery from the pulmonary artery Fyler:3101 SNOMEDCT_US:450301003 In this anomaly the function of the LMCA territory often requires extensive collateral formation from the RCA, which is often dilated. In the first month of life, physiologic pulmonary hypertension tends to preserve anterograde flow within the left coronary artery, and infants are usually asymptomatic. As pulmonary pressure drops, left-to-right shunting from the higher pressure left coronary arterial system to the lower pressure pulmonary arterial system occurs, and patients become symptomatic. Imaging findings may include markedly dilated collateral arteries and coronary veins.