A 52-year-old man has progressive exertional dyspnea and syncope. Echocardiography shows severe aortic stenosis with a calcified valve having only two functional cusps. Which statement about this condition is correct?

• A It predisposes to aortic root dilatation and infective endocarditis ✓
• B It typically becomes clinically significant in the seventh to eighth decade
• C It is usually caused by healed infective endocarditis
• D It is the least common congenital cardiac malformation

Explanation

B congenitally bicuspid aortic valve undergoes accelerated wear and calcification, becoming symptomatic roughly two decades earlier than a calcified tricuspid valve, so significant stenosis appears in the fifth to sixth decade, not the seventh to eighth. The abnormal cusp architecture also creates turbulent flow that predisposes to infective endocarditis and to dilatation of the ascending aorta independent of stenosis severity. It is actually among the most common congenital cardiovascular anomalies, affecting about 1 percent of the population, and it is unrelated to healed endocarditis.

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.