A 70-year-old man presents with progressive dyspnea and angina. Echocardiography reveals severe aortic valve stenosis with calcified, bicuspid valve leaflets. What is the most likely underlying etiology?

• A Rheumatic heart disease
• B Senile calcific degeneration of a tricuspid valve
• C Infective endocarditis with leaflet destruction
• D Congenital bicuspid aortic valve with superimposed calcification ✓

Explanation

A congenital bicuspid aortic valve is present in approximately 1-2% of the population and is the most common cause of aortic stenosis requiring valve replacement in the sixth to seventh decade. The abnormal hemodynamics accelerate calcific degeneration. Senile calcific degeneration typically affects a tricuspid valve in the eighth to ninth decade. Rheumatic aortic stenosis is almost always combined with mitral valve involvement. Robbins 10th ed, Chapter 12.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.