Quadricuspid aortic valve with mild aortic regurgitation and persistent foramen ovale: a multimodality imaging of rare concomitant findings.

Quadricuspid aortic valve is a rare congenital heart disease that is mostly detected incidentally during echocardiography or angiography, or at autopsy. This pathology is frequently associated with other congenital anomalies of the heart such as abnormalities of coronary ostia, coronary stenosis, aortic root dilation and coarctation of the aorta, as well as significant aortic valve dysfunction. Herein is presented the first documented case of an asymptomatic middle-aged male patient with incidentally diagnosed quadricuspid aortic valve and a preserved valve function associated with a patent foramen ovale and reverse right-left leak identified during the Valsalva maneuver. No other associated cardiac abnormalities were identified.