Abstract:
Aortic regurgitation
is caused by aortic
valve pathologies or
aortic root diseases.
Common causes of
aortic regurgitation
are a bicuspid aortic
valve, and calcific
and rheumatic aortic valve disease.
Aortic valve prolapse is defined as
displacement of
the aortic valve
structures downstream of a line connecting
the attachment points of the valvula. The incidence of aortic valve prolapse is about 1%. It is
more common in women, and in patients with
a bicuspid aortic valve. Nearly 30% of patients
with aortic valve prolapse have a bicuspid aortic valve. Non-bicuspid aortic valve prolapse
is mostly seen with concomitant mitral valve
prolapse. However, to our knowledge, isolated
severe aortic regurgitation due to aortic valve
prolapse in the absence of mitral valve prolapse
or a bicuspid aortic valve has not been reported.
A 28-year-old male patient was admitted to our
clinic with complaints of shortness of breath and
palpitations. There was no history of rheumatic
fever, trauma and valvular heart disease. In addition, he did not have a Marfanoid phenotype. The
ascending aorta was of normal width. On physical examination, a 3/6 grade diastolic murmur
was detected on the aortic focus. Arterial blood
pressure was 120/50 mmHg. An electrocardiogram revealed normal sinus rhythm with a heart
rate of 90/min. Transthoracic echocardiography
demonstrated isolated severe aortic regurgitation and a normal mitral valve with no evidence
of mitral valve prolapse (Figure A, Video 1*).
Transesophageal echocardiography was planned
to better assess the valve structures.