Aortic Dysplasia in Infancy Simulating Anomalous Origin of the Left Coronary Artery

A case is reported of an infant believed to have had anomalous origin of the left coronary artery. Clinical evaluation and angiography appeared to support the diagnosis. At necropsy, however, the left coronary was seen to arise from the aorta but was totally occluded by dysplastic changes which resulted in myocardial infarction and death of the patient. There was minimal aortic deformity produced by these changes, and no aortic gradient was present. Thus, this very rare case of minimal supravalvular aortic stenosis with left coronary artery occlusion was not recognizable clinically nor angiographically.