[A quadricuspid aortic valve passed unnoticed]

The quadricuspid aortic valve is a rare congenital anomaly that could be silent for a long time. It is mostly isolated but it may also be associated with other malformations, especially anomalies of the coronary artery insertion. It can lead to aortic regurgitation with several degrees of severity, and it should be diagnosed as soon as possible to avoid left ventricular dysfunction and its morbi-mortality. We report the case of a 67-years-old female patient with recent discovery of moderate aortic regurgitation, which has beneficiated from surgical closure of an atrial septal defect in her childhood, and who has never been diagnosed with a quadricuspid aortic valve.