Anomalous origin of the left coronary artery from the pulmonary trunk (Bland-Garland-White syndrome) is an important congenital malformation of the coronary circulation.The anomaly occurs in ap proximately 1 in 300,000 live births.Only 10% to 15% of affected infants will reach adulthood.The usual clinical presentation is that of the infant who sustains a myocardial infarction and develops congestive heart failure.Older children or adults can present with a continuous murmur and/or mitral regurgitation resulting from dysfunction of the ischemic papillary muscle.In some cases, the coronary anomaly is unsuspected until a previously well adolescent or adult experiences chest pain, heart failure, or sudden death.
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