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European Journal of Echocardiography 2005 6(3):221-224; doi:10.1016/j.euje.2004.09.008
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Copyright © 2004, The European Society of Cardiology

Rare cause of right heart failure: contained rupture of a sinus of Valsalva aneurysm associated intraventricular septal aneurysm

F. Mookadam*, J. Haley and Ed Mendrick

Division of Cardiovascular Diseases and Internal Medicine (F.M.,), Mayo Clinic and Mayo Foundation, 200 First Street SW, Rochester, MN 55904, USA

Received 5 July 2004; received in revised form 8 September 2004; accepted after revision 9 September 2004.

* Corresponding author. Tel.: +1 507 266 4046; fax: +1 507 266 0103. mookadam.farrowk{at}mayo.edu


  Abstract

Sinus of Valsalva aneurysm (SVA) is a rare congenital lesion described first in 1840 by John Thurnam (Cited by Boutefou JM, Moret PR, Hahn C, Hanf E. Aneurysms of the sinus of Valsalva: report of seven cases and review of the literature. Am J Med 1978;65:18–24). In most cases unruptured Sinus of Valsalva aneurysm (SVA) is clinically silent; however, if it progressively enlarges it may cause coronary artery compression, complete heart block, or right ventricular outflow tract obstruction (Meier JH, Seward JD, Miller FA, Oh J, Sarano ME. Aneurysms in the left ventricular outflow tract: clinical presentation, causes, and echocardiographic features. J Am Soc Echocardiogr 1998;11:729–45; D'Silva SA, Dalve BV, Lokhandwala YY, Kale PA, Tendolkar AG. Unruptured congenital aneurysm of the left sinus of Valsalva presenting as acute right heart failure. Chest 1992;101:578–79) or is a potential source of cerebrovascular emboli. (Shahrabani RM, Jairaj PS. Unruptured aneurysm of the sinus of Valsalva: a potential source of cerebrovascular embolism. Br Heart J 1993;69:266–67). In this report, we describe a case of right coronary sinus of Valsalva aneurysm with a contained rupture. The containing rupture is in intraventricular septal aneurysm; the patient presents with right-sided heart failure.

Keywords: Sinus of Valsalva aneurysm; Heart failure; Clinical presentation


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