Uncommon Sinus Valsalva Aneurysm Dissecting into the Interventricular Septum Linked to Infective Endocarditis: Insights from Echocardiography and CT Scans

Abstract

The sinuses of Valsalva are three pouch-like dilations at the root of the aorta, just above the aortic valve. Aneurysms of the sinuses of Valsalva can be congenital or acquired secondary to infective endocarditis. Here, we describe the case of a 41-year-old male patient who presented to the cardiology department of our hospital with fatigue and dyspnea on exertion for long periods. He had a history of infective endocarditis, smoking and substance abuse, like khat. Cardiovascular examination showed a murmur consistent with aortic regurgitation. Other systemic examinations, including those of the neurological, respiratory and abdominal, were unremarkable. Laboratory investigations were normal. Cardiac imaging, like transthoracic, trans-esophageal and cardiac computed tomography showed an aneurysm of the sinus Valsalva dissecting in to the interventricular septum. The patient was managed with metoprolol 25 mg, perindopril 10 mg and furosemide 20 mg and recommended for surgery but unfortunately it is not available in our country.