Frontal Bossing resulting from substantial aortic regurgitation?

  Hello,
  I am a 33 year old male, 6' 0", 175 lbs, with a substantial amount of aortic
  regurgitation due to a bicuspid aortic valve.  It is likely I will have this
  condition fixed via surgery (Ross procedure) this year.  In addition to high
  blood pressure, digital clubbing, cyanotic nails, and a fast pulse, I appear
  to have some frontal bossing of the forehead.  As far as I can tell this
  started some 2-4 years ago. Is frontal bossing a symptom of this kind of
  heart condition??  My cardiologist is investigating this but has yet to give
  me an answer.  If bossing is not a symptom of a regurgitating valve, then
  what might be causing it??  Thanks for your help.
  Glenn

[Cleveland Clinic, MD]

_

Dear Glenn,
Thank you for your question.  By frontal bossing I assume you mean an enlargement of the frontal bones.  Aortic valve problems do not cause this.  There are relatively few conditions that can cause this type of problems.   Some potential causes are Paget's disease which can cause enlargement of the bone.  It is more common in older men and is diagnosed with X-rays.  Parrot's bosses (also called Hot-cross-bun skull) is due to congenital syphilis and results in a prominence of the frontal and parietal bones resulting in a cross pattern to the skull.  It is usually seen in infants.  Acromegaly, or giantism can cause growth of the bones in adults and is due to a tumor producing growth hormone.  Your doctor should be able to work out what is causing this and what, if anything, needs to be done
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.