Abstract
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare but serious congenital heart defect that can cause myocardial ischemia, acute heart failure, and death if not promptly diagnosed and treated. We report two pediatric cases. The first involved a 4-month-old girl admitted with severe heart failure and pneumonia. ALCAPA was confirmed via echocardiography and the patient underwent emergency surgical reimplantation of the coronary artery. The second case was a 6-month-old boy with prior severe pneumonia and fulminant myocarditis. After prolonged intensive care, ALCAPA was diagnosed by CT imaging. Both patients underwent successful surgery and experienced significant recovery in cardiac function. Early diagnosis and surgical correction are essential to improve survival outcomes in ALCAPA cases.