Bicuspid aortic and pulmonary valves complicated by acute aortic dissection in a highly trained athlete – Case report and review of the literature

Acute aortic dissection is typically seen in the middle aged and elderly population, the majority of the cases are related to systemic hypertension and atherogenic process. In contrast, aortic dissection-related deaths in the young are rare and are mainly associated with genetically based disorders and congenital cardiac anomalies. One of the most recognized congenital risk factors that predispose to aortic dissection is the bicuspid aortic valve. This report describes an illustrative case of acute aortic dissection in a 29-year-old athlete secondary to previously unrecognized congenital bicuspid aortic valve. Moreover, further cardiac autopsy disclosed bicuspid pulmonary valve an exceedingly rare congenital valvular anomaly. The authors characterize and discuss, with emphasis on medicolegal approach, the mechanisms and interactions between these pathologic entities that led to the athlete’s sudden unexpected death.