A 21 year old woman with phenylketonuria, positive hepatitis B surface antigen and anomalous left coronary artery originating from the pulmonary artery (ALCAPA) was referred to our clinic to asses her current condition and to establish her further treatment. ALCAPA with concomitant mild mitral insufficiency were confirmed. She was asymptomatic and the studies provided evidence for not qualifying her to surgery. JRCD 2013; 1 (5): 25–27