IMAGES IN REVIEW: Single coronary artery associated with severe bicuspid aortic valve stenosis

A 75-year-old male with history of hypertension and hypercholesterolemia, presented with recurrent chest pain. Transthoracic echocardiography revealed severe bicuspid aortic valve stenosis. Pressure gradient over the aortic valve was 152 mm Hg and 94 mm Hg, peak and mean respectively; and calculated aortic valve area (AVA) was 0.77 cm^2, with concentric left ventricular hypertrophy and preserved global left ventricular systolic function (LVEF) at 65%.