Presentation
We report here earliest presentation of ruptured sinus of valsalva aneurysm which had been misdiagnosed as ventricular septal defect. [dergipark.org.tr]
Usually, ruptured sinus of Valsalva presents with cardiac failure. There may be a history of trauma or infective endocarditis preceding the rupture. Asymptomatic paediatric presentation of ruptured sinus of Valsalva is rare. [cambridge.org]
Here we present a rare case of a right sinus of Valsalva aneurysm, which ruptures into the right atrium. [peertechzpublications.com]
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]
Cardiovascular
- 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]
Psychiatrical
- Impulsivity
He had bilateral carotid bruits and a hyperdynamic left ventricular impulse with a thrill over the left sternal border. A loud, harsh, continuous grade 5/6 murmur, loudest in systole, was best heard near the left lower sternal border. [ncbi.nlm.nih.gov]
Neurologic
- Altered Mental Status
Case Presentation A 42-year-old farmer with no relevant medical history came to the emergency department with dyspnea, chest pain, and altered mental status. [cvcasejournal.com]
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]
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]
Microbiology
- Taenia Solium
The differential diagnosis of ventricular cystic masses includes infections secondary to Echinococcus that cause hydatid cyst or Taenia solium that causes cysticercosis, capillary hemangiomas, cystic thrombi, congenital blood cysts, and intracardiac tumors [cvcasejournal.com]
Jugular Venous Pressure
- Prominent A-Wave
Jugular Venous Pressure (JVP) was elevated (7cm above sternal angle) with prominent A wave. Arm span to height ratio was <1. On auscultation of chest, S1 was normal and S2 was normally split with loud P2 component. [peertechzpublications.com]
Treatment
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]
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]
Surgical repair remains the preferred method of treatment, although transcatheter closure devices are an acceptable treatment for patients with suitable anatomy and high risk for cardiac surgery. [ncbi.nlm.nih.gov]
Treatment includes blood pressure control but surgical repair may be needed, especially if the aneurysm ruptures. [en.wikipedia.org]
Prognosis
Treatment and prognosis Surgical repair with a Bentall procedure can be performed. [radiopaedia.org]
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]
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 overall prognosis is good when surgery is timely performed. Nonetheless, acute rupture may have a dismal prognosis. [sciencerepository.org]
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]
Etiology
Left to right shunting is the usual underlying etiology of decompensation. [ncbi.nlm.nih.gov]
Etiology Sinus of Valsalva aneurysm may be either congenital or acquired. [radiopaedia.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]
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]
Cardiac tamponade may occur if the rupture involves the pericardial space. [4] Etiology Primary causes of sinus of Valsalva aneurysm (SVA) are congenital. [emedicine.medscape.com]
Epidemiology
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
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]
[…] 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]
There is a higher reported incidence in Asian groups.[8][9] Pathophysiology Non-ruptured sinus of Valsalva aneurysm is usually asymptomatic. [ncbi.nlm.nih.gov]
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]
Prevention
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]