Quadricuspid aortic valve by transthoracic echocardiography

Area of Science:

• Cardiology
• Cardiac Surgery
• Medical Diagnostics

Background:

• A 55-year-old woman presented with symptoms suggestive of heart failure, including palpitations, atypical chest pain, and exertional dyspnea.
• Electrocardiogram (ECG) revealed left ventricular hypertrophy, prompting further cardiac investigation.

Observation:

• Transthoracic Doppler echocardiography identified a quadricuspid aortic valve with four equal-sized cusps.
• The echocardiogram also revealed moderate central aortic regurgitation due to abnormal leaflet coaptation.
• Characteristic "X" shape during diastole and rectangular appearance during systole were noted for the quadricuspid valve.

Findings:

• The patient's heart failure symptoms were presumed to be a direct result of the aortic valve insufficiency.
• The quadricuspid aortic valve, though rare, was identified as the likely underlying cause of the regurgitation.

Implications:

• This case highlights the importance of echocardiography in diagnosing rare congenital cardiac anomalies like quadricuspid aortic valves.
• Periodic echocardiographic monitoring is crucial for patients with quadricuspid aortic valves to track potential progression of regurgitation.
• Successful management of symptoms through treatment and follow-up underscores the effectiveness of conservative approaches in select cases.