Which auscultatory sound is most suggestive of a bicuspid aortic valve?

The systolic ejection click is most suggestive of a bicuspid aortic valve due to the characteristic nature of this auscultatory finding in the context of this specific valvular anomaly. A bicuspid aortic valve typically leads to a distinct sound during early systole, known as the systolic ejection click, which is attributed to the abnormal closure and motion of the aortic valve leaflets.

This click occurs because the leaflets, being fused or otherwise abnormal, exhibit a different kinematic pattern compared to normal trileaflet valves, leading to an audible sound as the valve opens. The timing of this click, occurring shortly after the first heart sound (S1), adds further specificity since it aligns with the rapid outflow of blood from the left ventricle into the aorta.

Recognizing this auscultatory sound is crucial for diagnosing a bicuspid aortic valve, particularly in patients presenting with symptoms of aortic stenosis or those with a family history of the condition. This is because bicuspid aortic valve can lead to a range of complications, including aortic stenosis and regurgitation, which may emerge over time. Thus, identifying the systolic ejection click during auscult