Physiological Insights From Asymptomatic Severe Valvular Disease in a Highly Trained Athlete

Parameters relied on as tools for prognostication in valvular disease can be confounded by athletic physiological remodeling. This case describes how cardiopulmonary exercise testing and multimodality imaging may be helpful in assessment of a 46-year-old female athlete with bicuspid aortic valve and subaortic membrane with associated asymptomatic severe mixed aortic valve disease.