Question

Example

a 37 year old man present with an asymptomatic diastolic murmur. Echocardiography shows a bicuspid aortic valve with more than mild aortic regurgitation with:
Vena contracta: 5mm
Descending aorta: Holodiastolic flow reversal in descending thoracic aorta, but not proximal abdominal aorta.
CW Doppler: AR signal less dense than antegrade flow. PHT = 400ms. VTI(AR) = 150cm
LVOT diameter(LVOT(D)) = 2.8cm
VTI(LVOT) = 24cm
Mitral annulus diameter = 3.1 cm
VTI(MA) = 12cm

Answer 1

The patient exhibits significant aortic regurgitation as evidenced by a bicuspid aortic valve and echocardiography findings including holodiastolic flow reversal, suggesting a need for close monitoring or intervention.

Step-by-step explanation:

The discussion focuses on a 37-year-old man with an asymptomatic diastolic murmur and bicuspid aortic valve with associated aortic regurgitation. The echocardiography findings include a vena contracta measurement of 5mm, presence of holodiastolic flow reversal in the descending thoracic aorta, an aortic regurgitation (AR) signal that is less dense than antegrade flow on continuous wave (CW) Doppler, a pressure half-time (PHT) of 400ms, a velocity-time integral (VTI) for AR of 150 cm, a left ventricular outflow tract (LVOT) diameter of 2.8 cm, a VTI for the LVOT of 24cm, a mitral annulus diameter of 3.1 cm, and a VTI for the mitral annulus of 12 cm. These findings suggest a significant degree of aortic regurgitation.

The aortic valve functions to prevent the backflow of blood from the aorta into the left ventricle during diastole. It normally has three cusps, but in the case of a bicuspid aortic valve, there are two, which can lead to complications such as stenosis or regurgitation over time. The presence of a holodiastolic flow reversal in the aorta indicates a significant regurgitation.