Presentation
Aneurysmal dilation less commonly affects the left sinus and rupture into the right atrium is still rarer and a chronic insidious presentation as in this case is odd. [ncbi.nlm.nih.gov]
Entire Body System
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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]
Respiratoric
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Sore Throat
A parturient at 37-week gestation complained of a sore throat and cough that started 3 days before admission, followed 1 day later by fever, dizziness, breathlessness, and palpitation on exertion. [ncbi.nlm.nih.gov]
Gastrointestinal
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Regurgitation
OBJECTIVES: Recurrent or newly developing aortic regurgitation is a critical problem after the repair of ruptured sinus of Valsalva aneurysm. [ncbi.nlm.nih.gov]
Cardiovascular
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Continuous Murmur
Patients with a coronary aneurysm alone do not generally exhibit continuous murmurs; however, murmurs may be detected in the presence of a fistula. [ncbi.nlm.nih.gov]
On physical examination, a grade 3/6 continuous murmur was heard in the left lower sternal border. [link.springer.com]
The diagnostic work-up for a pre-cordial continuous murmur mostly consists of echocardiography. [ecrjournal.com]
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Heart Disease
We briefly review the association between congenital heart disease, situs ambiguus, and ciliary dysfunction. [ncbi.nlm.nih.gov]
University of Medicine, Silesian Center for Heart Diseases, Zabrze, Poland b Computed Tomography Department, Silesian University of Medicine, Silesian Center for Heart Diseases, Zabrze, Poland Keywords Catheterization. [revespcardiol.org]
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Diastolic Murmur
On auscultation, a grade 4/6 early diastolic murmur was heard over the left lower sternal border and Erb's area with a thrill. Crepitating rales were heard over bilateral basal lung fields. [ncbi.nlm.nih.gov]
His physical examination revealed a thrill localized in the 5th intercostal space on the right edge of the sternum and systolic-diastolic murmur beginning from the aortic focus and spreading to the neck and back along the right edge of the sternum. [unboundmedicine.com]
On auscultation S1 was normal and S2 was soft with grade III/VI diastolic murmur in aortic area. Patient was properly investigated. ECG showed sinus rhythm and X-ray chest was showing cardiomegaly. [medcraveonline.com]
The heart rate was regular, and systolic and diastolic murmurs were heard over the right sternal border. [jtd.amegroups.com]
Shunt from the aortic root to the left ventricle may produce a diastolic murmur similar to that of aortic insufficiency. Pulmonary rales may be present from progressive left heart failure. [chdbabies.com]
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Heart Murmur
We report the case of a 35-year-old pregnant woman who presented at the hospital for cardiac evaluation due to the presence of a heart murmur. The patient was asymptomatic and in her 4th month of pregnancy. [ncbi.nlm.nih.gov]
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]
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]
Treatment
The conventional treatment of RSVA is surgical repair under cardio-pulmonary bypass (CPB) or percutaneous catheter closure. [ncbi.nlm.nih.gov]
Prognosis
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]
The postoperative prognosis appears to be better if the surgeon can avoid aortic valve replacement due to the subsequent prosthetic dysfunction [ 16 ]. [ncbi.nlm.nih.gov]
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
Discussion was made on the etiology and differential diagnosis. [ncbi.nlm.nih.gov]
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]
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
This case is unusual because of the patient's young age at presentation, the absence of predisposing factors, and the isolation of a nonvaccine serotype 21, which revealed the epidemiologic changes of invasive pneumococcal disease. [ncbi.nlm.nih.gov]
Global Tuberculosis Control: epidemiology, strategy, financing. World Health Organization. WHO/HTM/TB/2009.411.WHO Report;(2006), , Surveillance of Tuberculosis in Europe-Euro TB. [citeulike.org]
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]
The association of aneurysm with hypertension and smoking, as well as local atheromatous degenerative changes, coronary and cerebral atherosclerotic etiology simultaneously support, but the controversy is served after the publication of several epidemiological [clinicazurbano.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 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]
The two cases that are presented in this article have different pathophysiology. In the first case, the etiology is atherosclerosis causing coronary artery disease, degeneration and aneurysm formation of the right coronary sinus. [heartviews.org]
Prevention
An early aggressive approach is recommended to prevent worsening symptoms and more extensive disease. [ncbi.nlm.nih.gov]