Anomalous origin and course of the circumflex artery diagnosed by transthoracic echocardiography in an adult patient, usefulness of the retro aortic coronary sign. Case report
DOI:
https://doi.org/10.37615/retic.v9n2a7Keywords:
coronary vessel anomalies, echocardiography, coronary circulation, case reportsAbstract
A 23-year-old female patient presented with recurrent syncope, with normal initial studies and a positive tilt table test. Transthoracic echocardiography identified the RAC (retroaortic coronary artery) sign, which prompted a coronary CT angiography that confirmed an anomalous origin of the circumflex artery arising from the right coronary artery with a retroaortic course, without high-risk features. Given its benign course and the lack of causal relation to the symptoms, conservative management was indicated, with a favorable outcome. This case highlights the importance of recognizing indirect echocardiographic signs of coronary anomalies and the need for anatomical stratification to guide appropriate therapeutic decision-making.
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Copyright (c) 2026 Adrian Bolívar-Mejía, Pina Isabel Munera Muñoz, Luisa Maria Cardona
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