Echocardiographic assessment of anomalous origin of the left coronary artery from the pulmonary artery

Transthoracic echocardiography of a 4-month-old boy with heart failure revealed poor left ventricular contractility with severe mitral regurgitation. Deformation analysis revealed significantly decreased circumferential strain in the anterior and anteroseptal segments. Furthermore, post-systolic shortening was evident in the anterior and lateral segments. The pulmonary arterial short-axis view showed that the left coronary artery originated from the pulmonary artery and color Doppler flow mapping showed retrograde flow in the left coronary artery. These findings were quite helpful for concluding the anomalous origin of the left coronary artery from the pulmonary artery.