Differential Diagnosis for Coarse Systolic Flutter of the Aortic Valve Leaflets
Single Most Likely Diagnosis
- Aortic regurgitation: This condition is the most likely cause of coarse systolic flutter of the aortic valve leaflets seen in the parasternal long-axis (PLAX) view on transthoracic echocardiography (TTE). The flutter is due to the retrograde flow of blood from the aorta into the left ventricle during systole, causing the valve leaflets to vibrate.
Other Likely Diagnoses
- Endocarditis: Infective endocarditis can cause destruction of the aortic valve leaflets, leading to regurgitation and subsequent flutter.
- Aortic valve prolapse: Prolapse of the aortic valve leaflets can cause regurgitation and lead to the observed flutter.
- Rheumatic heart disease: This condition can cause scarring and thickening of the aortic valve leaflets, leading to regurgitation and flutter.
Do Not Miss Diagnoses
- Aortic dissection: Although less likely, an aortic dissection can cause aortic regurgitation and subsequent flutter. Missing this diagnosis could be catastrophic, as aortic dissection is a life-threatening condition.
- Traumatic aortic valve injury: Trauma to the chest can cause injury to the aortic valve, leading to regurgitation and flutter. This diagnosis should not be missed, as it may require urgent surgical intervention.
Rare Diagnoses
- Congenital aortic valve abnormalities: Certain congenital abnormalities, such as a bicuspid or unicuspid aortic valve, can cause aortic regurgitation and flutter.
- Marfan syndrome: This genetic disorder can cause dilation of the aortic root and subsequent aortic regurgitation, leading to flutter.
- Rheumatoid arthritis: This autoimmune disorder can cause inflammation of the aortic valve, leading to regurgitation and flutter. However, this is a rare cause of aortic valve disease.