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An 8 month old infant was admitted to the hospital with worsening food intolerance and tachypnea. ECG showed deep Q waves in V4-V6. Echocardiography revealed an abnormally dilated left ventricle (5.5 cm) with ejection fraction of 20%. In addition, the left coronary sinus was not seen to give arise to any coronary artery and the origin of left main coronary artery (LCA) could not be delineated. CT Angiography (CTA), being a non invasive method of choice to diagnose anomalous coronary anatomy, was done on a 384-slice dual source scanner (Siemens SOMATOM Force). The CTA, revealed an anomalous origin of the LCA from the proximal right pulmonary artery (RPA)(long white arrow) which was seen to be dividing into a long left anterior descending (LAD) and a circumflex branch (white asterisk)(Fig. 1 A, B) and a smaller accessory LAD artery from the right coronary sinus which had a prepulmonic course (Fig …