pediatrics
Bicuspid Aortic Valve
Diagnosis of Bicuspid Aortic Valve
Physical examination Echocardiography Diagnosis is by physical examination findings and echocardiography. Physical examination usually reveals a prominent early systolic ejection sound (click) at the apex and base of the heart. This finding is often best heard with the patient sitting; the examiner listens at the apex for a click just after the first heart sound (S1), simulating a prominent split of S1. There may be a basal systolic murmur due to aortic stenosis or a high-pitched diastolic murmur if aortic regurgitation is present. Echocardiography shows the characteristic finding of fusion of two of the three aortic valve leaflets. Fusion of the right coronary and left coronary leaflets is the most common morphology. Children with fusion of the right coronary and noncoronary leaflets are more likely to have progression of valve dysfunction and to require intervention during childhood. 