A heart in a heart: a case report of spontaneous flail of bicuspid aortic valve

BACKGROUND: Aortic regurgitation is attributed to congenital and acquired abnormalities of the aortic valve or aortic valve supporting structures. The most common cause of aortic regurgitation is atherosclerotic degeneration of the valve, especially in the presence of a bicuspid aortic valve. CASE SUMMARY: A 25-year-old Persian man with no past medical history, developed dyspnea since 1 week before his first visit to the physician. He was an active person up to this time, and had no history of trauma or chest pain. Transthoracic echocardiography showed severe aortic regurgitation in the context of flail bicuspid aortic valve, with no evidence of endocarditis. Laboratory tests including blood cultures were negative for infection. The patient underwent aortic valve replacement and the diagnosis was confirmed at time of surgery. CONCLUSION: This case represents noninfective and nontraumatic spontaneous flail of bicuspid aortic valve. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13256-021-03211-8.