Title : A rare dual cardiac anomaly: Quadricuspid aortic valve and wenckebach AV block
Abstract:
Quadricuspid Aortic Valve (QAV) is an exceptionally rare congenital cardiac anomaly characterized by the presence of four cusps instead of the usual three, often leading to valvular dysfunction. Equally intriguing, Mobitz type I second-degree Atrio Ventricular (AV) block, or Wenckebach phenomenon, represents a distinct conduction abnormality within the AV node. To date, no documented case has reported the coexistence of these two conditions in a single patient.
We report the case of a young lady who presented with chest pain and shortness of breath. Clinical examination and investigations revealed a mild aortic regurgitation due to QAV, alongside evidence of Mobitz type I AV block on electrocardiography. This unique combination has not been described previously and raises important considerations about the interplay between valvular structure and conduction pathways.
This case highlights the importance of a comprehensive cardiovascular evaluation in patients with unexplained bradyarrhythmias or valvular abnormalities. The diagnosis of QAV requires a high index of suspicion and thorough echocardiographic assessment, while recognition of Mobitz type I AV block is critical to guide management and avoid unnecessary interventions.
In summary, this case contributes valuable insight into the spectrum of QAV presentations and emphasizes the necessity for vigilance in detecting associated conduction disturbances. Reporting such rare associations broadens understanding and may inform future diagnostic and therapeutic guidelines.
