A Severe Restrictive Aortic Regurgitation Resulting From Valve Tenting by Unusual Aortic Chordae Tendineae Strands

We report a case of a 74-year-old man who presented with progressive dyspnea and hypertension (200/63 mm Hg) without any chest pain. He had a history of chronic hypertension and heart murmur several years ago. Physical examination revealed a diastolic murmur with an acute pulmonary edema that required admission in the intensive care unit. The ECG results were normal. There was no fever and no inflammatory syndrome; hemocultures were sterile. Transthoracic echocardiography (Figure 1, online-only Data Supplement Movies I and II) showed a severe aortic regurgitation on a mildly thickened valve with a mild dilatation of the aortic root (Valsalva aortic diameter=46 mm; 25 mm/m2) with a normal annulus diameter (22 mm) and suspected intra-aortic mobile linear echoes.Figure 1. Transthoracic echocardiography (parasternal longitudinal view) showing severe aortic regurgitation with mild dilatation of the aortic …