Quadricuspid aortic valve in an asymptomatic young adult: a case report

Quadricuspid aortic valve (QAV) is a rare congenital heart disease, ranking behind bicuspid and unicuspid aortic valves in terms of the incidence of congenital aortic valve abnormalities. When symptoms are present, they are typically related to aortic regurgitation, manifesting as shortness of breath, nocturnal dyspnea, and palpitations, or aortic stenosis, which presents with exertional dyspnea, angina, or syncope.

We present the case of an asymptomatic male, diagnosed with a QAV during a routine examination. Despite the absence of clinical symptoms, a thorough general physical examination, including cardiac auscultation, revealed signs suggestive of valvular abnormality. The diagnosis was confirmed via transthoracic echocardiography.

For QAV, the diagnostic process typically includes transthoracic echocardiography, which allows for initial confirmation of the valve morphology. In addition, computed tomography (CT) coronary angiography provides detailed information on valvular morphology and helps identify any associated coronary stenosis. In cases of QAV, a CT aortogram is also crucial to assess potential aortic root dilation, a known complication of this congenital anomaly.

This case emphasizes the importance of routine physical examination in diagnosing rare congenital heart conditions like QAV, even in asymptomatic individuals. Early diagnosis and appropriate imaging are essential for timely management, particularly in preventing the progression of associated complications such as aortic regurgitation or root dilation.