Aortic valve insufficiency due to myxomatous degeneration: a case report and literature review.

Myxomatous degeneration is a non-inflammatory degenerative process leading to disruption of the fibrosa layer of the valve with acid mucopolysaccharide accumulation. This type of degeneration commonly affects the mitral valve leading to mitral regurgitation; however, few cases have been reported regarding myxomatous degeneration of the aortic valve leading to acute decompensated heart failure. We report a case of myxomatous degeneration of the aortic valve as an etiology of acute decompensated heart failure to highlight the importance of considering myxomatous degeneration as an underlying etiology of symptomatic aortic insufficiency. A 64-year-old female presented with progressively worsening dyspnea, cough, and peripheral edema over a one-month duration. Clinical evaluation and imaging studies revealed aortic valve regurgitation (AVR). Subsequent aortic valve replacement was performed. The histopathology report was consistent with myxomatous degeneration of the aortic valve. Upon symptom improvement, the patient was discharged home. Subsequent transesophageal echocardiogram demonstrated a normal hemodynamic profile across the bioprosthetic valve without aortic regurgitation or paravalvular leak. We highlight a unique presentation of heart failure secondary to myxomatous degeneration of the aortic valve. Furthermore, a review of available literature on myxomatous degeneration of the aortic valve was conducted to illustrate the importance of early diagnosis and proper treatment to improve the patients' quality of life.