A Rare Cause of Dyspnea: Sudden Rupture of Aortic Valsalva Sinus Aneurysm

Arikan, Erdinc Mehmet; Karagöz, Arıf; Bayata, Serdar; Yilik, Levent; Ünlüer, Erden Erol

doi:10.1155/2013/909302

Cited by 4 publications

(13 citation statements)

References 9 publications

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“…However, the challenge is to establish an early and accurate diagnosis; these aneurysms are typically clinically silent until they rupture. 3 Rarely, SVAs can lead to myocardial ischemia, either by directly compressing a coronary artery or by thrombotic embolization. 1,2,8,9 Ruptured SVAs typically present in the 3rd or 4th decade of life with nonspecific symptoms, including chest pain, dyspnea, and fatigue.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, presentation and hemodynamic stability depend on the involved sinus and the vector of the consequent shunt within the associated cardiac chamber. 3,4 Regardless, heart failure will occur within hours or weeks. 2,9 Many authors have reported single sinus aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 This condition (prevalence, 0.09%-3.5%) arises from a congenital or acquired anomaly. 2,3 A ruptured SVA causes rapidly progressive heart failure. Genetic mutations (such as that in Marfan syndrome) and embryologic developmental defects underlie congenital presentations.…”

mentioning

confidence: 99%

“…Genetic mutations (such as that in Marfan syndrome) and embryologic developmental defects underlie congenital presentations. [1][2][3][4] Acquired conditions (such as infection, atherosclerosis, or trauma) can exacerbate the destruction of connective tissue and lead to aneurysm formation. [1][2][3][4] Developmental biological explanations for congenital heart disease (CHD) and its relationship with situs ambiguus and SVA formation are complex.…”

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confidence: 99%

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Ruptured Sinus of Valsalva Aneurysm Associated with Situs Ambiguus, Isolated Levocardia, and Polysplenia

Golestaneh¹,

Kashef²,

Hiser³

et al. 2017

Texas Heart Institute Journal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Ruptured Sinus of Valsalva Aneurysm Associated with Situs Ambiguus, Isolated Levocardia, and Polysplenia

Golestaneh¹,

Kashef²,

Hiser³

et al. 2017

Texas Heart Institute Journal

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“…6 These aneurysms are typically congenital and are associated with ventricular septal defects (40% of patients) and aortic regurgitation (30% of patients). [6][7][8] Acquired SVAs are also associated with bacterial endocarditis and syphilis. 5 The major complication of a SVA is rupture into the right heart chambers, or rarely into the left chambers.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Endocarditis Caused by Lactobacillus acidophilus Leading to Rupture of Sinus of Valsalva Aneurysm

Encarnación¹,

Loranger²,

Bharatkumar³

et al. 2016

Texas Heart Institute Journal

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L actobacilli are gram-positive, rod-shaped bacteria that are rarely infectious, and their presence as commensal organisms in the gastrointestinal tract is associated with protection against pathogens, stimulation of the immune system, and positive effects on colonic health and the host's nutrition. Nevertheless, lactobacilli have also been identified in some clinical reports as causal agents of dental caries, infectious endocarditis, urinary tract infections, and intra-abdominal, liver, and spleen abscesses. Endocarditis due to Lactobacillus is associated with impaired immunity, structural heart disease, recent surgery, prolonged antibiotic therapy, and severe comorbid conditions.2 Some clinical reports show a 30% mortality rate associated with endocarditis caused by lactobacilli.3 Probiotic agents that serve as entry vehicles for Lactobacillus have been identified as a relatively new risk factor in the genesis of these infections. 4 Case ReportA 48-year-old man with a history of paroxysmal supraventricular tachycardia (ablated in the past), mild aortic regurgitation, and the implantation (4 years earlier) of upper and lower dental bridges, presented at our emergency department. He reported exertional shortness of breath, increased lower-extremity edema, 3 months of intermittent fever ranging from 100.4 to 102.9 °F, and recent left-upper-quadrant abdominal pain.The patient was lethargic. His vital signs included a blood pressure of 112/43 mmHg, a heart rate of 113 beats/min, a respiratory rate of 20 breaths/min, and an oral temperature of 99 °F. His examination was notable for jugular venous distention (12 cm), a grade III/IV holosytolic murmur heard over the left lower sternal border, crackles in the lung bases bilaterally, splenomegaly, 3+ pitting edema bilaterally up to the knees, and scattered red macules anterior to the shins. His laboratory results indicated pancytopenia, acute renal failure, and hypoalbuminemia. His white blood cell count was 3.9 × 10 3 /µL, hemoglobin 7.1 g/dL, platelet count 114 × 10 3 /µL, serum creatinine 4.51 mg/dL, and albumin 2.3 g/dL. The urinalysis showed many bacteria, hyaline and granular casts, microscopic hematuria, and 50 white blood cells per highpower field. Blood cultures from 2 different venipuncture sites grew Lactobacillus acidophilus.A transthoracic echocardiogram revealed a left ventricular ejection fraction of 0.60 and a membranous ventricular septal defect with a mobile, echodense, vegetative mass 1.1 cm in diameter, moving between the left ventricular outflow tract and the right ventricle. Mild dilation of the aortic root was found, together with mild aortic regurgitation.Initial antibiotic treatment with empiric vancomycin and piperacillin/tazobactam was switched to penicillin on treatment day 4 for a 6-week course after species Case Reports

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Unruptured Multiple Sinus of Valsalva Aneurysms

Omeh

Makaryus

2020

Case Reports in Radiology

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Sinus of Valsalva aneurysm (SVA) is a rare cardiac condition occurring in about 0.09% of the general population, with potential for grave complications. Unruptured sinus of Valsalva aneurysms of all three sinuses in the same patient are even more rare. There are congenital, inherited, or acquired causes. Noninvasive cross-sectional imaging modalities, consisting of color Doppler echocardiography, cardiac computed tomographic angiography (CCTA), and cardiac magnetic resonance imaging (MRI), make the diagnosis. Treatment is mainly by open surgical reconstruction. However, transcatheter techniques are gaining popularity with noninferior outcomes in selected cases. We report the diagnosis and successful management of a patient with an unusual presentation of multiple unruptured SVAs of all three sinuses, and we conducted a review of the English medical literature.

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A Rare Cause of Dyspnea: Sudden Rupture of Aortic Valsalva Sinus Aneurysm

Cited by 4 publications

References 9 publications

Ruptured Sinus of Valsalva Aneurysm Associated with Situs Ambiguus, Isolated Levocardia, and Polysplenia

Ruptured Sinus of Valsalva Aneurysm Associated with Situs Ambiguus, Isolated Levocardia, and Polysplenia

Bacterial Endocarditis Caused by Lactobacillus acidophilus Leading to Rupture of Sinus of Valsalva Aneurysm

Unruptured Multiple Sinus of Valsalva Aneurysms

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