Screening first-degree relatives of patients with bicuspid aortic valve should be performed with which imaging modality?

Screening first-degree relatives of patients with bicuspid aortic valve should be performed with which imaging modality?

• A. Chest X-ray
• B. Cardiac MRI
• C. Cardiac CT angiography
• D. Echocardiography

Answer: (D)

Screening relatives for bicuspid aortic valve is best done with transthoracic echocardiography because it directly visualizes valve morphology and measures the proximal aorta in a quick, safe, and cost-effective way. Echocardiography can reveal whether the aortic valve has two cusps instead of three and assess any associated aortopathy, stenosis, or regurgitation, which are important to identify early in relatives who may share the congenital condition. It is widely available, does not expose patients to ionizing radiation, and is well suited for routine screening. Chest X-ray isn’t reliable for detecting valve shape or measuring aortic dimensions. Cardiac MRI offers excellent detail and no radiation but is less practical as a first-line screen due to higher cost and limited access in some settings. Cardiac CT angiography provides excellent anatomical detail but involves radiation and contrast, making it less ideal for routine screening in asymptomatic relatives.

Screening relatives for bicuspid aortic valve is best done with transthoracic echocardiography because it directly visualizes valve morphology and measures the proximal aorta in a quick, safe, and cost-effective way. Echocardiography can reveal whether the aortic valve has two cusps instead of three and assess any associated aortopathy, stenosis, or regurgitation, which are important to identify early in relatives who may share the congenital condition. It is widely available, does not expose patients to ionizing radiation, and is well suited for routine screening.

Chest X-ray isn’t reliable for detecting valve shape or measuring aortic dimensions. Cardiac MRI offers excellent detail and no radiation but is less practical as a first-line screen due to higher cost and limited access in some settings. Cardiac CT angiography provides excellent anatomical detail but involves radiation and contrast, making it less ideal for routine screening in asymptomatic relatives.