Asymptomatic female patient with ruptured sinus valsalva aneurysm: a case report

Abstract

Abstract. Sinus of Valsalva aneurysms (SVA) are relatively rare lesions with a variable clinical presentation. Rupture of a SVA (RSVA) often causes hemodynamic instability due to intracardiac shunting or cardiac tamponade, therefore immediate diagnosis and urgent treatment are required. In this case, we presented a 53-year-old asymptomatic female patient, who had a ruptured right SVA with a fistula from the right sinus of Valsalva to the right ventricle (RV) of unknown etiology. A 53-year-old female patient with a history of erythema nodosum (EN) and hypertension (HT) for ten years was referred to our clinic, from department of dermatology for detailed evaluation of HT and target tissue damage. She was asymptomatic and incidentally diagnosed with a ruptured right sinus of Valsalva aneurysm during the transthoracic echocardiography (TTE). SVA are relatively rare anomalies. SVA may be either congenital or secondary to such underlying diseases as syphilis, bacterial endocarditis, atherosclerosis, and aortic dissection. In case of rupture, biventricular failure may occur as a result of systemic-pulmonary shunting. Surgical repair has been the traditional treatment choice of these aneurysms. Our case is interesting because the diagnosis was a coincidental finding in an asymptomatic patient.

Key words: Sinus Valsalva aneurysm, rupture, incidentally

Keywords

• Sinus Valsalva aneurysm, rupture, incidentally

References

1. Hope J. A treatise on the diseases of the heart and great vessels, (3rd ed.) Philadelphia: Lea & Blanchard, 1839, pp 466-471.
2. Reichert CL. Ruptured sinus Valsalva aneurysm, a rare cause of heart failure. Neth Heart J 2008; 16: 60-61.
3. Rothbaum DA, Dillon JC, Chang S, Feigenbaum H. Echocardiographic manifestation of right sinus of Valsalva aneurysm. Circulation 1974; 49: 768-771.
4. Wahab A, Khan HS, Wahab S. Rupture of Sinus of Valsalva Aneurysm Presenting with Left Ventricular Failure. JIACM 2008; 9: 209-211
5. Moustafa S, Mookadam F, Cooper L, et al. Sinus of Valsalva aneurysms-47 years of a single center experience and systematic overview of published reports. Am J Cardiol 2007; 99: 1159-1164.
6. Weijerse A, van der Schoot MJ, Maat LP, et al. Cardiac tamponade due to a ruptured aneurysm of the sinus of valsalva. J Card Surg 2008; 23: 256-258.
7. Cancho ME, Oliver JM, Fernández MJ, et al. Transesophageal echocardiographic diagnosis of a ruptured sinus of valsalva aneurysm with right atrium fistula. Rev Esp Cardiol 2001; 54: 1236-1239.
8. Van Son JA, Danielson GK, Schaff HV, et al. Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation 1994; 90: 1120-1129.

9. Kumar P, Banerji A. Transcatheter closure of ruptured sinus of valsalva aneurysm. Catheter Cardiovasc Interv 2010; 76: 774-776.
10. Arora R, Trehan V, Rangasetty UM, et al. Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm. J Interven Cardiol 2004; 17: 53-58.
11. Karakurt C, Koçak G, Selimoğlu A, Ozen M. Aortic aneurysm: a rare complication of ulcerative colitis. Anadolu Kardiyol Derg 2007; 7: 461-462.
12. Larsen S, Bendtzen K, Nielsen OH. Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management. Ann Med 2010; 42: 97-114.