Severe aortic stenosis typically presents with reduced exercise tolerance, exertional chest pains, or syncope. We report on a case of a young female on therapeutic anticoagulation and a history of nephrotic syndrome, who presented with subacute limb ischaemia resulting from axillary artery thrombus. Urgent echocardiogram demonstrated a bicuspid aortic valve with critical stenosis, and she underwent surgical aortic valve replacement. Her presenting symptoms resolved after three months of warfarin therapy. This case highlights the importance of systemic evaluation of unexplained arterial thrombosis.
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