Spontaneous Rupture of a Bicuspid Aortic Valve in a Middle-Aged Weightlifter.

We describe a 58-year-old Caucasian male weightlifter who presented with acute shortness of breath after finishing his extensive exercise routine. Acute aortic valve regurgitation, due to spontaneous rupture of a bicuspid aortic valve, was diagnosed. Urgent surgical intervention was carried out, during which the bicuspid aortic valve was resected and replaced with an On-X bileaflet mechanical valve. The patient remains asymptomatic and is treated with warfarin, being in excellent physical condition 4 years after aortic valve replacement. LEARNING POINTS: Spontaneous rupture of a bicuspid aortic valve, after heavy weightlifting, is a very rare cause of acute aortic valve regurgitation.Echocardiography is of vital importance to distinguish the reason for this medical emergency from other possible causes.Prompt diagnosis and surgical treatment can achieve excellent long-term results. © EFIM 2021.