[Anomalous origin of left circumflex artery from the right sinus of Valsalva and left anterior descending artery with double intramyocardial tract: a rare case of angina].

Abstract

We report a rare case of angina in a patient with anomalous left circumflex artery origin from the right sinus of Valsalva with retroaortic course and a double myocardial bridging of the anterior descending artery. In a modified apical 4-chamber view during transthoracic echocardiography the "crossed aorta sign" (or "RAC sign") was found. Usually, the diagnosis of this congenital anomaly of coronary circulation is established during coronary angiography. In our case, the diagnosis was suspected during angiography but confirmed by echocardiography and coronary computed tomography angiography.