A 47 year old white man was hospitalised for cardiac examination. A blowing diastolic heart murmur prompted us to perform echocardiography during which a severe aortic regurgitation caused by an enlarged aortic root accompanied by a dilated ascending aorta (maximal diameter 52 mm) was visualised (panels A–C). No findings indicated mitral valve prolapse.

The patient’s clinical features (panels D and E) …