Rupture of a sinus of Valsalva aneurysm as an unusual cause of chest pain – case report
Authors:
M. Mikolášková 1; O. Ludka 1,2; M. Holická 1; J. Foukal 3; M. Šebo 4; J. Ničovský 4; J. Špinar 1,2
Authors place of work:
Interní kardiologická klinika LF MU a FN Brno
1; Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně
2; Radiodiagnostická klinika LF MU a FN Brno
3; Centrum kardiovaskulární a transplantační chirurgie, Brno
4
Published in the journal:
Kardiol Rev Int Med 2014, 16(5): 391-394
Category:
Cardiology Review
Summary
Rupture of a sinus of Valsalva aneurysm is a rare and serious heart disease which can endanger the patient’s life. Early diagnosis and proper therapeutic treatment can significantly affect the patient’s prognosis. We describe the case of a 44‑year– old man admitted to the Cardiology Department of the University Hospital Brno with typical chest pain and non‑specific changes on electrocardiogram and positive troponin T. Transthoracic echocardiography revealed a non‑coronary sinus aneurysm and communication between the aorta and the right atrium, which was confirmed by computed tomography. The patient was referred to the cardiothoracic surgery centre and the aneurysm was resected. The communication between the aorta and the right atrium was closed via pericardial patch. The aneurysm formation can be caused by the metabolic effects of corticosteroids which the patient had been using for a long time. This case report suggests that careful clinical examination and noninvasive methods remain an essential diagnostic procedure.
Keywords:
aneurysm of sinus of Valsalva – congenital heart disease – rupture – shunt
Zdroje
1. Hope J. A treatise on the diseases of the heart and great vessels. 3rd ed. Philadelphia: Lea & Blanchard 1839: 466– 471.
2. Au WK, Chiu SW, Mok CK et al. Repair of ruptured sinus of Valsalva aneurysm: determinants of long‑term survival. Ann Thorac Surg 1998; 66: 1604– 1610.
3. Kouchoukos NT, Blackstone EH, Doty DB et al (eds.). Congenital sinus of Valsalva aneurysm and aortico‑ left ventricular tunnel, Kirklin/ Barratt‑ Boyes Cardiac Surgery: morphology, diagnostic criteria, natural history, techniques, results and indications. 3rd ed. Philadelphia: Churchill Livingstone 2003: 911– 927.
4. Azakie A, David TE, Peniston CM et al. Ruptured sinus of Valsalva aneurysm: early recurrence and fate of the aortic valve. Ann Thorac Surg 2000; 70: 1466– 1470.
5. Angelini P. Aortic sinus aneurysm and associated defects: can we extrapolace a morphogenetic theory from pathologic findings? Tex Heart Inst J 2005; 32: 560– 562.
6. Dong HJ, Zhou YL, Huang XS. Complication of interventional treatment: noncoronary sinus of Valsalva aneurysma ruptured into the right atrium. Chin Med J (Engl) 2007; 120: 611– 613.
7. TurgemanY, Bloch L, Atar S et al. Anginal syndrome due to giant unruptured sinus of Valsalva aneurysm. Int J Cardiovasc Intervent 2001; 4: 39– 42.
8. Regueiro Abel M, Penas Lado M, López Ciudad Vet al. Sinus of Valsalva aneurysm as a cause of acute myocardial infarction. Rev Esp Cardiol 2002; 55: 77– 79.
9. van Son JA, Danielson GK, Schaff HV et al. Long‑term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation 1994; 90 (5 Pt 2): II20– 29.
10. Lijoi A, Parodi E, Passerone GC et al. Unruptured aneurysm of the left sinus of Valsalva causing coronary insufficiency. Tex Heart Inst J 2002; 29: 40– 44.
11. Takach TJ, Reul GJ, Duncan JM et al. Sinus of Valsalva aneurysm or fistula: management and outcome. Ann Thorac Surg 1999; 68: 1573– 1757.
12. Adams JE, Sawyers JL, Scott HW Jr. Surgical treatment for aneurysms of the aortic sinuses with aorticoatrial fistula. Surgery 1957; 41: 26–42.
14. Ohara N, Miyata T, Sato O et al. Aortic aneurysm in patients with autoimmune diseases treated with corticosteroids. Int Angiol 2000; 19: 270– 275.
15. Reilly JM, Savage EB, Brophy CM et al. Hydrocortisone rapidly induces aortic rupture in a genetically susceptible mouse. Arch Surg 1990; 125: 707– 709.
Štítky
Paediatric cardiology Internal medicine Cardiac surgery CardiologyČlánok vyšiel v časopise
Cardiology Review
2014 Číslo 5
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