A 60-year-old male presented with sudden onset chest pain and pulmonary
oedema. Investigation confirmed torrential aortic regurgitation of a
bicuspid valve. At surgery a ruptured chordae tendineae was identified
which had been supporting the left-right cusp commissure with loss of
attachment to the aortic wall. This case demonstrates that chordae
tendineae may be present as a supporting structure of the aortic valve,
and rupture can be a rare cause of torrential aortic regurgitation,
similar in pathogenesis to how it may be associated with acute severe
mitral regurgitation.