# An Unusual Case of Bicuspid Aortic Valve With Prolapse Masquerading as Cusp Perforation

## TL;DR

A 58-year-old man with a bicuspid aortic valve and prolapse developed severe heart failure, mimicking a cusp perforation, emphasizing the need for early diagnosis and team-based care.

## Contribution

Highlights a rare case where aortic valve prolapse mimicked cusp perforation, leading to cardiogenic shock.

## Key findings

- Patient presented with NSTEMI and rapidly developed cardiogenic shock due to aortic insufficiency.
- ECG was normal on presentation, illustrating the dynamic and deceptive nature of valvular pathology.
- Case underscores the importance of interdisciplinary management in complex valvular heart disease.

## Abstract

We present a unique clinical scenario of a 58-year-old male with a past medical history of hypertension who initially presented with chest pain and was ruled in for non-ST elevation myocardial infarction (NSTEMI) but rapidly developed respiratory failure secondary to aortic insufficiency complicated by cardiogenic shock (CS), attributed to aortic valve prolapse. Intriguingly, the patient had a normal ECG on presentation, underscoring the dynamic nature of valvular pathology. The development of CS highlights the importance of early recognition, prompt diagnosis, and interdisciplinary management in such complex cases.