Congenital absence of left pulmonary artery with collateralization from all major coronary arteries

Unilateral pulmonary artery agenesis (UPA) is a rarely-observed congenital anomaly with diverse clinical signs and symptoms. It is most often diagnosed in childhood due to the high mortality rate prior to adulthood. This report describes the case of a 71-year-old woman who presented with exertional chest pain, dyspnea and palpitations and who was diagnosed as having left pulmonary artery (LPA) agenesis, hypoplastic left lung supplied by collateralization from each of the three normal major coronary arteries, and atrial fibrillation.