Hemopericardium and cardiac tamponade as presenting findings of anomalous left coronary artery syndrome complicated by transmural myocardial infarction

Anomalous origin of the left coronary artery from the pulmonary artery most commonly presents in infancy with clinical features of dilated cardiomyopathy, congestive heart failure or cardiogenic shock as a result of myocardial ischemia. We report the first presentation of this disorder with hemorrhagic pericardial effusion and cardiac tamponade as a result of a transmural myocardial infarction. The list of other causes of hemorrhagic pericardial effusion must now include anomalous left coronary artery syndrome.