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Severe mitral regurgitation: a misleading presentation.

Anomalous left coronary artery arising from the pulmonary artery (ALCAPA) is a rare congenital anomaly commonly presenting in infancy with severe congestive cardiac failure due to myocardial ischemia. We present a two and half year old child who presented with severe mitral regurgitation and near normal left ventricular function and turned out to be having ALCAPA. High pulmonary artery pressures prevented coronary steal into the pulmonary arteries and preserved LV function (near noprmal) at presentation.