Science and Education Publishing American Journal of Medical Case Reports 2 12 2014 11 26 Syncope in a Previously Healthy Young Adult: Undiagnosed Aortic Stenosis, Dilation and Coarctation Requiring Emergent Surgery 269 271 EN Edlira Rruci Andi Ka?ani Gentian Vyshka Biomedical and Experimental Department, Faculty of Medicine, University of Medicine in Tirana, Albania Efrosina Kajo AJMCR20142123 10.12691/ajmcr-2-12-3 2014 11 04 2014 11 20 2014 11 26 Aortic stenosis is a valvular heart disease that needs particular attention; due to the fact that asymptomatic patients may go undiagnosed for periods of time long enough to cause severe morbidity. On the other hand, aortic stenosis frequently is accompanied with other cardiac pathologies, such as a post-stenotic dilation, and coarctation. Imputed as a possible causative factor for sudden cardiac death, among other, aortic stenosis is a common finding in the setting of a bicuspid valve. We present the case of a previously young adult that suffered an episode of syncope during a football game. Exertion and sport activities are well-known situations that might provoke an abrupt manifestation of the latent valvular pathology. We dealt with an aortic stenosis of severe grade, accompanied with dilation and coarctation of aorta, in an individual with bicuspid aortic valve. A major heart surgery intervention was performed, with replacement of the valve, correction of the dilated arch and removal of the coarcted segment. Close follow-ups and monitoring are warranted even in asymptomatic patients, when the stenosis is uncovered as an incidental finding, during routine checkups.