The Authors present the case of an asymptomatic 36-year-old man, affected by Down syndrome, with an unexpected quadricuspid aortic valve coupled with the anomalous origin of the left circumflex coronary artery from the proximal right coronary artery. This is the first report of the concomitant presence of these three conditions.
Keywords: Aortic insufficiency; Down syndrome; coronary anomalies; echocardiography; quadricuspid aortic valve.