Approximately 5–10% of patients present with acute endocarditis. 3 In the present case, there was no such precipitating cause for the sudden rupture. Conventionally, surgical repair of the RSVA has been the mainstay of therapy. [invasivecardiology.com]

OBJECTIVES: The aim of the present study was to study the feasibility and approaches to device closure of ruptured sinus of Valsalva (RSOV). [ncbi.nlm.nih.gov]

We report here earliest presentation of ruptured sinus of valsalva aneurysm which had been misdiagnosed as ventricular septal defect. [dergipark.org.tr]

Habitualmente cursa de forma asintomática, pero debe tenerse presente que con frecuencia coexisten junto a otros defectos cardíacos y, al producirse la rotura, éstos pueden seguir una evolución inesperada e inexplicable. [analesdepediatria.org]

• Asymptomatic

  In this case report, we describe a 65-year-old asymptomatic patient with a continuous cardiac murmur leading to the diagnosis of a previously unsuspected ruptured sinus of Valsalva. Surgery was suggested even tough the patient was asymptomatic. [ecrjournal.com]

  Ruptured sinus of Valsalva aneurysm in pregnancy can be asymptomatic, and women with such a rupture can have a normal full-term pregnancy and give birth to healthy babies. [ncbi.nlm.nih.gov]

  Case report A 26-year-old asymptomatic man with a known small supracristal VSD and mild aortic regurgitation (AR) was referred to our institution for progressive left ventricular (LV) enlargement. [ehjcimaging.oxfordjournals.org]

• Congestive Heart Failure

  Patient was diagnosed as a case of ruptured sinus of Valsalva into IVS, moderate aortic regurgitation with complete heart block which had presented with congestive heart failure and bradycardia. [acronyms.thefreedictionary.com]

  […] abrupt onset of congestive heart failure. [cardiothoracicsurgery.biomedcentral.com]

  […] unruptured is usually asymptomatic but when ruptured presents with progressive exertional dyspnea, fatigue, chest pain and that can lead to congestive heart failure if left untreated. [orpha.net]

  The acute symptoms subsided after administration of digitalis and sodium restriction, but congestive heart failure persisted. The third history is a 21-year-old woman who had previously been well. [clinicalgate.com]

• Atrial Septal Defect

  defect (VSD) and an atrial septal defect (ASD). [ehjcimaging.oxfordjournals.org]

  Associated defects were bicuspid aortic valve in one, trivial pre-existing aortic regurgitation (AR) in five, coarctation of the aorta in one, and secundum atrial septal defect in one. [ncbi.nlm.nih.gov]

  Approximately, 50% of individuals with SOVA also have associated Ventricular Septal Defect (VSD) [10]. Bicuspid aortic valve, Coarctation of aorta (CoAo), pulmonary stenosis, and atrial septal defect are less commonly associated anomalies. [peertechzpublications.com]

  Other associated abnormalities less frequently found are pulmonary stenosis, patent ductus arteriosus, atrial septal defect, subaortic stenosis, and Fallot's Tetralogy. 7 Regarding the atrial septal aneurysm, 1,15 this is an infrequent finding in adult [elsevier.es]

• Chest Pain

  Title in English Rupture of a sinus of Valsalva aneurysm as an unusual cause of chest pain - case report Authors MIKOLÁŠKOVÁ Monika LUDKA Ondřej HOLICKÁ Mária FOUKAL Jakub ŠEBO M. NIČOVSKÝ J. [muni.cz]

  Symptoms often include acute chest pain, pain in the right upper quadrant, cough, difficulty breathing, swelling in the legs, and decreased urine output. [nmcheartcare.ae]

  Aneurysms of right sinus that rupture present with acute-onset chest pain that resolves after some time but is soon followed by right-sided heart failure symptoms which are progressive in nature. [peertechzpublications.com]

  A 47-year-old male presented with a history of sudden-onset chest pain followed by progressively increasing dyspnea worsening to New York Heart Association (NYHA) Class IV for 15 days. [invasivecardiology.com]

  pain and that can lead to congestive heart failure if left untreated. [orpha.net]

• Continuous Murmur

  The diagnostic work-up for a pre-cordial continuous murmur mostly consists of echocardiography. [ecrjournal.com]

  Later that day, after the procedure, it was noted that the patient had a recurrence of continuous murmur. The TTE did not visualize the Amplatzer VSD device, and chest X-ray showed that the device had embolized to the right pulmonary artery. [ncbi.nlm.nih.gov]

  We present a case of a 23-year-old man who presented with a 20-day history of symptoms of worsening breathlessness; examination showed elevated jugular venous pressure, high volume pulse, S3 and a continuous murmur. [casereports.bmj.com]

• Heart Block

  […] left aortic sinus produces bulge on left upper heart border in region of LA appendage Rarely, a large aneurysm of the right aortic sinus leads to bulge on right heart border Usually the aneurysm dilates the aortic ring which can lead to aortic insufficiency [learningradiology.com]

  Patient was diagnosed as a case of ruptured sinus of Valsalva into IVS, moderate aortic regurgitation with complete heart block which had presented with congestive heart failure and bradycardia. [acronyms.thefreedictionary.com]

  Complete heart block following transcatheter closure of ruptured sinus of Valsalva aneurysm. J Invasive Cardiol 2012;24:E314-7. 9. Sakakibara S, Konno S. Congenital aneurysm of the sinus of Valsalva. Anatomy and classification. [nigjcardiol.org]

  Distortion and compression may also cause myocardial ischemia (by coronary artery compression) and, possibly, heart block (by compressing the conduction system). [chdbabies.com]

  Death from congestive heart failure typically occurs within a year after rupture. 36 Sudden death follows perforation into the pericardium, and syncope and sudden death are occasional sequelae of complete heart block caused by a ruptured 15 or unruptured [clinicalgate.com]

• Cardiomegaly

  Chest X-ray may also show cardiomegaly with increased pulmonary vascularity. Blood cultures should be taken at admission to rule out active infective endocarditis. [peertechzpublications.com]

  Chest X-ray showing the massive cardiomegaly. After his complete evaluation, surgery was recommended. [ncbi.nlm.nih.gov]

  Chest radiography showed cardiomegaly and an electrocardiogram revealed the presence of sinus tachycardia, with no significant abnormalities in the tracing. [revespcardiol.org]

  Chest radiography showed grade III cardiomegaly and a right basal pleural effusion (Figure 1B). [cvcasejournal.com]

  Chest roentgenogram showed cardiomegaly with increased pulmonary vascular markings. The electrocardiogram was unremarkable. [invasivecardiology.com]

• 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]

• Prolapse

  Furthermore, transthoracic echocardiographic examination (TTE) indicated that the patient had a large VSD and prolapse of the noncoronary cusp of the aorta into the VSD due to severe aortic regurgitation. [ncbi.nlm.nih.gov]

  In addition to dilation of the annulus and valvular prolapse, secondary contributing factors may be hypoplasty of the adjacent cusp or prolapse of both cusps and annulus due to decreased support. [journals.plos.org]

  Less common associated lesions are pulmonary stenosis, a bicuspid aortic valve, mitral insufficiency with or without prolapse, a coarctation of the aorta, a patent ductus arteriosus and tricuspid insufficiency. 1–4 Because of the congenital weakness, [ecrjournal.com]

  Transthoracic echocardiogram (TTE) revealed Type I right RSOVA into right ventricular outflow tract (RVOT), small subaortic VSD, and mild AR due to prolapse of the right coronary cusp [Figure 2] and Videos 1, 2]. There was no RVOT obstruction. [nigjcardiol.org]

  By definition, the true sinus of Valsalva aneurysm arises from above the aortic annulus, in contrast to the prolapsing aortic cusp below the annulus. [omicsonline.org]

• Stroke

  The incidence of stroke after operation for type A aortic dissection has been reported at 2–16% in recent studies [42]. Preoperative shock status is largely related to the incidence of postoperative stroke. [passeidireto.com]

  Specialty Cardiology Complications Rupture, heart failure, stroke Diagnostic method Echocardiogram, cardiac CT scan, cardiac MRI scan Treatment Blood pressure control, surgery Medication Beta-adrenoceptor antagonists Prognosis Median survival after rupture [en.wikipedia.org]

  Depending on the genetic cause of familial TAAD in particular families, they may have an increased risk of developing blockages in smaller arteries, which can lead to heart attack and stroke. [ Read More ] [icdlist.com]

  Literatur American Heart Association (2005) 2005 Heart and stroke statistical update. [springerlink.com]

• Confusion

  The frequent presence of tricuspid valve tissue or a prolapsed AV leaflet trapped within a VSD can look like a “windsock” and further cause confusion. In our patient, the small size of the aneurysm made the “windsock” difficult to visualize. [journals.lww.com]

  Symptoms may be confused with those of acute myocardial infarction. [chdbabies.com]

  The clinical picture can sometimes mimic pulmonary thromboembolism that can be a catastrophic confusion when a unnecessary thrombolytic therapy is administrated. [romanianjournalcardiology.ro]

• Agitation

  No association with patent foramen ovale was observed with agitated saline solution (baseline and Valsalva maneuver). [elsevier.es]

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]

Sections Sinus of Valsalva Aneurysm Overview Background Pathophysiology Etiology Epidemiology Prognosis Show All Presentation History Physical Examination Show All DDx Workup Imaging Studies Procedures Show All Treatment Approach Considerations Medical [emedicine.medscape.com]

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]

Percutaneous treatment of a ruptured sinus Valsalva aneurysm with double orifices [Turk Kardiyol Dern Ars] Turk Kardiyol Dern Ars. 2013; 41(1): 59-63 | DOI: 10.5543/tkda.2013.58812 Percutaneous treatment of a ruptured sinus Valsalva aneurysm with double [archivestsc.com]

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]

Treatment options include surgical repair or percutaneous device closure. The factors determining the choice of treatment includes anatomic location of the RSOV and associated cardiac defects. [peertechzpublications.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]

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]

Early diagnosis and proper therapeutic treatment can significantly affect the patient's prognosis. [muni.cz]

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 overall prognosis is good when surgery is timely performed. Nonetheless, acute rupture may have a dismal prognosis. [sciencerepository.org]

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]

Left to right shunting is the usual underlying etiology of decompensation. [ncbi.nlm.nih.gov]

Root replacement or Ross procedure maybe used if severe local septic etiology. Complications Rupture into RV > RA > LV > IVS/PA leads to formation intracardiac fistulae or tamponade. [pie.med.utoronto.ca]

Etiology Sinus of Valsalva aneurysm may be either congenital or acquired. [radiopaedia.org]

The etiology of the aneurysm seems atherosclerotic as suggested by age of the patient, atherosclerotic changes visualized on computed tomography imaging of the aorta and histopathology of the surgically excised aneurysm. [annalspc.com]

the life expectancy without treatment is approximately four years.[8] Surgery carries a 1% risk of intra-operative death with higher risks associated with infected aneurysms, and 5- to 10-year survival rates following surgery range from 82-97%.[8] Epidemiology [en.wikipedia.org]

Sections Sinus of Valsalva Aneurysm Overview Background Pathophysiology Etiology Epidemiology Prognosis Show All Presentation History Physical Examination Show All DDx Workup Imaging Studies Procedures Show All Treatment Approach Considerations Medical [emedicine.medscape.com]

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]

Epidemiology and Demographics Sinus of valsalva aneurysm is found in approximately 9 people out of 10000 in general populatin.[8] Sinus of valsalva comprise 3.5% of all congenital heart defects. sinus of valsalva affects males four times more likely than [wikidoc.org]

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]

[…] of SVAs originate from the right sinus of Valsalva, whereas SVAs originating from noncoronary (10-30%) and left sinuses (< 5%) are exceedingly rare. [1] SVA is commonly associated with aortic valve regurgitation and/or ventricular septal defect. [2] Pathophysiology [emedicine.medscape.com]

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]

An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease. [ncbi.nlm.nih.gov]

Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3]. Secondary Prevention There are no established measures for the secondary prevention of [disease name]. [wikidoc.org]

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]