Typical Cardiac Chest Pain in an 18-year Old: A Case of Symptomatic Congenital Heart Disease

Introduction: ALCAPA syndrome is a rare congenital heart defect that is present in only 1/300,000 live births and typically presents in infancy as left heart failure. In cases of untreated ALCAPA, mortality reaches up to 85% in the first year of life. Rarely, patients are asymptomatic in childhood and present as adults with signs and symptoms of myocardial ischemia. Case Description: An 18-year-old female with a history of ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) syndrome status-post repair presents with exertional chest pain associated with nausea, light headedness, and shortness of breath that began during marching band practice. Of note, the …