Quadricuspid Aortic Valve Presenting with Aortic Regurgitation in Adulthood: A Case Report

ABSTRACT: Quadricuspid aortic valve (QAV) is a rare congenital cardiac anomaly characterized by four aortic cusps instead of the normal three. It is most commonly associated with progressive aortic regurgitation and is often diagnosed incidentally on echocardiography. A woman in her fifties presented with palpitations and exertional dyspnea (New York Heart Association Class II). Clinical examination revealed an early diastolic murmur at the left sternal border. Transthoracic echocardiography demonstrated a QAV with Hurwitz and Roberts Type F morphology and moderate aortic regurgitation with preserved left ventricular systolic function. Transoesophageal echocardiography confirmed central cusp malcoaptation. The patient was managed conservatively and remained stable at 6-month follow-up. QAV is an uncommon congenital anomaly that may present in adulthood with aortic regurgitation. Echocardiography is essential for diagnosis and classification. Early recognition has important implications for surveillance and procedural planning.