Presentation
We present a case report of a ruptured sinus of Valsalva aneurysm (SVA) that presented as aortic insufficiency following bacterial endocarditits in a cardiac transplant patient. [ncbi.nlm.nih.gov]
Entire Body System
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Recurrent Infection
There was no AR progression, recurrence, infective endocarditis, or device embolization. CONCLUSION: In appropriately selected patients with ruptured SOVA, TCC is an attractive alternative to surgery with encouraging short- and mid-term outcomes. [ncbi.nlm.nih.gov]
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Turkish
Case Report 50-year-old Turkish man was admitted with a history of weakness, and mild dyspnea with a 2-year diagnosis history as an aneurysm of the ascending aorta. There was no history of recent chest pain or injury. [omicsonline.org]
Gastrointestinal
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Right Upper Quadrant Pain
We report the case of a 28-years-old man which was referred to hospital due to right upper quadrant pain without irradiation and emphasizing a dynamic dyspnea and fatigue. [romanianjournalcardiology.ro]
Cardiovascular
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Heart Murmur
We here report the case of a 26 years old pregnant woman who was referred to our cardiac center for the evaluation of a heart murmur. [ncbi.nlm.nih.gov]
Full Text A 36-year-old man was referred to our hospital for a recent finding of a heart murmur. He had no relevant medical history except paroxysmal palpitations in the previous three months. [elsevier.pt]
Conclusion A rupture of a sinus of Valsalva has to be taken into account in the differential diagnosis of a continuous heart murmur, even though the patient looks healthy and is asymptomatic. [ecrjournal.com]
DISCUSSIONS In young patients (mostly male – 4:1 ratio – and middleaged), the ruptured aneurysms of sinus of Valsalva may initially be asymptomatic or may be manifested by acute heart failure with the emergence of new heart murmurs imposing a differential [romanianjournalcardiology.ro]
Musculoskeletal
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Normal Stature
Concerning the etiologic diagnosis, it was ruled out syphilis (VDRL negative) and Marfan syndrome (no eyes disorder, normal stature, normal fingers)3,4. [romanianjournalcardiology.ro]
Skin
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Dermatitis
She had no history of medical problems, except for atopic dermatitis (AD). Blood cultures identified methicillin-sensitive Staphylococcus aureus. [ncbi.nlm.nih.gov]
Workup
Surgery has good reputation having a [2] Transcatheter closure (TCC) of ruptured sinus of Valsalva aneurysm (RSOVA) appears to be a reasonable alternative. [3], [4] A thorough workup of location, size, proximity to neighboring structures, complications [nigjcardiol.org]
Axis
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Left Axis Deviation
His electrocardiogram showed left axis deviation and evidence of left ventricular (LV) hypertrophy. The chest X-ray except for cardiomegaly with LV apex was inconclusive. Upon TTE, patient was diagnosed with RSOVA draining into the left ventricle. [annals.in]
T Wave
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T Wave Abnormality
Electrocardiogram can objectify left/right ventricle hypertrophy and non-specifi c ST segment/ T wave abnormalities. The management of RSVA is guided by clinical and echocardiographical fi ndings. [romanianjournalcardiology.ro]
Treatment
OBJECTIVES: Different surgical strategies have been evolved for the surgical treatment of ruptured sinus of Valsalva aneurysm (RSVA) from simple primary closure to patching of the rupture site by a dual chamber approach. [ncbi.nlm.nih.gov]
Although the classical treatment method of ruptured SVA is surgical repair, percutaneous closure devices may be used as a reliable alternative method in suitable patients. [unboundmedicine.com]
Prognosis
Urgent surgical repair for ruptures aneurysms Many recommend surgical repair of non-ruptures aneurysms as well Complications Rupture (see above) Myocardial infarction Heart block Right ventricular outflow tract obstruction Cardiac tamponade Sudden death Prognosis [learningradiology.com]
The prognosis of ruptured SOVA is poor and patients usually succumb to acute cardiac failure [ 2 ]. Early diagnosis and treatment are generally associated with a good outcome. [link.springer.com]
Prognosis in patients with a ruptured aneurysm who have not undergone surgical repair may be poor, with survival beyond 1 year uncommon. [chdbabies.com]
A good prognosis depends on early diagnosis and prompt surgical intervention. However, we think the best surgical procedure is modified Button Bental procedure, as we did in our case. [omicsonline.org]
In case of rupture, prognosis is poor and therefore repair is always required. [ecrjournal.com]
Etiology
An anatomic etiology of symptoms may be suspected with heart auscultation (murmur), and diagnosis is made by a routine echocardiogram or, if the patient is suspected of having coronary disease as the etiology of symptoms, an angiogram. [hqmeded-ecg.blogspot.com]
Asian countries than in the West. 2 Though acquired aneurysms of the aortic sinus have been described postoperatively 9 as also due to atherosclerosis, 10 the typical saccular shape and location of the aneurysm in our patient suggested a congenital etiology [invasivecardiology.com]
Infectious etiologies that weaken elastic tissue and are associated with acquired Sinus of Valsalva aneurysm include syphilis, bacterial endocarditis, and tuberculosis. [ncbi.nlm.nih.gov]
Conclusion Percutaneous closure of ruptured sinus of Valsalva is easier when it's etiology, location, size, distant from coronary artery ostium, distance from aortic valve, neighboring structures, associated congenital defects, and complications are properly [nigjcardiol.org]
Epidemiology
Epidemiology The estimated rate of Sinus of Valsalva aneurysm is approximately 0.09% of the general population, based on large autopsy series. SOVAs comprise up to 3.5% of all congenital heart defects. [ncbi.nlm.nih.gov]
Cardiac tamponade may occur if the rupture involves the pericardial space. [1] Epidemiology Frequency United States SVA was present in 0.09% of cadavers in a large autopsy series and ranged to 0.14-0.23% in a Western surgical series. [4] Two-dimensional [emedicine.medscape.com]
Pathophysiology
Pathophysiology Image courtesy of Professor Peter Anderson DVM PhD and published with permission PEIR, University of Alabama at Birmingham, Department of Pathology Sinus of Valsalva Aneurysm: Gross; a beautiful picture of windsock opening of aneurysm [wikidoc.org]
Associated conditions include: Syphilis Trauma Endocarditis Atherosclerosis Marfans (diffuse dilatation) Uncommon – Ehlers Danlos (other connective tissue disorders), Takayasu arteritis (other vasculitides), post AV replacement Pathophysiology Congenital [pie.med.utoronto.ca]
Pathophysiology Non-ruptured sinus of Valsalva aneurysm is usually asymptomatic. However, non-ruptured sinus of Valsalva aneurysm can lead to cardiac arrhythmias; atrial fibrillation and complete heart block have both been described. [ncbi.nlm.nih.gov]
Pathophysiology Aneurysmal dilatation of the sinuses of Valsalva occurs when the aortic media is defective, allowing separation of the media from the aortic annulus fibrosus. [chdbabies.com]
[…] intracardiac shunting caused by rupture of the SVA into the right side of the heart. [1] Approximately 65-85% of SVAs originate from the right sinus of Valsalva, while SVAs originating from noncoronary (10-30%) and left sinuses ( 5%) are exceedingly rare. [2] Pathophysiology [emedicine.medscape.com]
Prevention
An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease. [ncbi.nlm.nih.gov]
A mean survival period of 3,9 years in patients with untreated ruptured sinus of Valsalva aneurysms has been reported. 1 An early, aggressive approach is recommended to prevent clinical deterioration. 1,2,4,6 Operative procedures include simple plication [ecrjournal.com]