Type A Quadricuspid Aortic Valve; Rarer Than a Four-Leaf Clover, an Example Of Availability Heuristic

Abstract

The natural history of the quadricuspid aortic valve (QAV) is poorly understood, due to its exceeding rarity, with an incidence rate between 0.00028–1%. It classically presents between 40–60 years, with aortic incompetence (AI), palpitations, chest pain or heart failure. The rarity of the condition predisposes it to an innate cognitive bias to automatically exclude it from the differential diagnoses. Hereafter we present the case of a 46 year-old male who presented with chest pain, palpitations and heart failure in the presence of an Type A QAV with AI.