['Bicuspid aortic valve disease (BAV) is the most common cardiac valve pathology. BAV is associated with aortic root disorders. The literature has few case reports identifying this condition during routine physical exam.', 'A 42-yr-old military reservist flight medic presented for his annual military flight physical. He was found to have a faint cardiac murmur. His past family and medical history were remarkable for familial essential hypertension and being told at age 9 that he had a "murmur." He was referred for cardiology consultation, echocardiography, stress testing, and a computerized tomography angiogram (CTa), which identified BAV with a 4.3-cm aortic root aneurysm. A follow-up at 1 yr was recommended. In the interim he developed severe aortic valve insufficiency, a 4.6-cm aortic root aneurysm. The valve and aortic root were repaired and a single left anterior descending coronary artery lesion was bypassed during surgery. The flight medic made a full recovery but was not returned to flight status.'] Does aortic Root Aneurism Found in a 42-Year-Old epitomize the Importance of Auscultation in Routine Exams?