A large aneurysm of a left sinus of Valsalva invading the interventricular septum – a rare cause of syncope

Hattaoui, Mustapha El; Charei, N.; Boumzebra, Drissi; Chraibi, Saïd; Bennis, Ahmed

doi:10.1016/s0828-282x(08)70606-8

Cited by 8 publications

(7 citation statements)

References 5 publications

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“…Clinically, an aneurysm arising from the LCS can be found extending into the pulmonary artery or left atrium when arising from the base; into the left ventricle when arising from the portion between the sinus wall and the annulus; into the extracardiac position when arising from the higher region; and occasionally dissecting the interventricular septum or the interatrial septum [6,16]. In our group, the aneurysms arising from the LCS had an extracardiac protrusion in 1 case and ruptured into the LV in the other.…”

Section: Discussionmentioning

confidence: 99%

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Echocardiographic diagnosis of rare pathological patterns of sinus of Valsalva aneurysm

et al. 2017

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ObjectiveTo evaluate the value and improve the diagnostic accuracy of echocardiography in the diagnosis of a sinus of Valsalva aneurysm (SVA) with rare pathological patterns.MethodsEchocardiographic features and surgical findings from 270 Chinese patients with SVA treated in the last 18 years (1995–2013) at the Union Hospital were compared retrospectively; 22 of 270 cases had rare patterns.ResultsThe patients with SVA, a rare origin, a rare extending position, or a rare course accounted for 3.4%, 7.4%, and 0.4% of the 270 cases, respectively. The three most common aneurysmal complications of the patients with rare patterns were severe aortic regurgitation (16), obstruction of the ventricular outflow tract or valvular orifice (3), and conduction disturbance (3). The origin, course, extending position and rupture status of the SVAs determined by echocardiography were entirely consistent with surgical findings in 81.8% of the 22 cases. With the exception of one failed diagnosis of an aneurysmal wall dissection and one misdiagnosis of a descending aortic dissection, the echocardiographic results of SVA complications and associated cardiovascular lesions were also confirmed.ConclusionWe could accurately diagnose SVAs with rare pathological patterns by echocardiographic identification of distinguishing features. However, for several conditions, we could not accurately identify the origin or course of the aneurysm or define its relationship to adjacent structures using conventional echocardiography alone. Therefore, we recommend combining conventional echocardiography with different imaging techniques, such as transesophageal echocardiography, three-dimensional echocardiography, computed tomography angiography, and aortic angiography.

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Section: Discussionmentioning

confidence: 99%

“…Preoperative diagnosis of SVAs with rarely occurring patterns is most frequently made in Westerners in combination with an aortogram or a series of CT angiograms [4,16,17]. In contrast, the preoperative diagnosis in Chinese patients is based primarily on echocardiograms.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic diagnosis of rare pathological patterns of sinus of Valsalva aneurysm

et al. 2017

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“…There have been reports of syncope in patients with unruptured aneurysms but these have mostly been in the context of either brady-or tachyarrhythmias. [2][3][4] In this case syncope was not associated with arrhythmia but by marked transient hypotension resulting from RVOT E60 Sinus of Valsalva Aneurysm obstruction in effect behaving like pulmonary valve stenosis.…”

Section: Abstract: Sinus Of Valsalva; Aneurysm; Obstruction; Syncopementioning

confidence: 85%

“…Right ventricular tract obstruction is a recognized consequence of large aneurysms but the symptom most associated with this is dyspnea. There have been reports of syncope in patients with unruptured aneurysms but these have mostly been in the context of either brady‐ or tachyarrhythmias 2–4 . In this case syncope was not associated with arrhythmia but by marked transient hypotension resulting from RVOT obstruction in effect behaving like pulmonary valve stenosis.…”

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confidence: 84%

Sinus of Valsalva Aneurysm—An Unusual Cause of Syncope

Sohal¹,

Rajani²,

Belder³

2010

Echocardiography

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Sinus of Valsalva aneurysms (SOVA) are rare anomalies which often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient right ventricular outflow tract (RVOT) obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope. SOVA are rare anomalies that often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp, which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient RVOT obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope.

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“…Unruptured SOVAs are asymptomatic in most cases or may present with nonspecific symptoms and signs such as dyspnea, heart murmur palpitation, and angina. The three most common complications of SOVAs are severe aortic insufficiency, obstruction of the ventricular outflow tract or valvular orifice, and conduction disturbance [ 5 ]. Involvement of the cardiac conduction system can lead to cardiac arrhythmias, such as atrial fibrillation, Tachy-Brady arrhythmia, or complete heart block [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

An Unusual Cause of Recurrent Syncope: Sinus of Valsalva Aneurysm

Johari

Deraman

Saat

et al. 2021

Cureus

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Sinus of Valsalva aneurysm (SOVA) is a rare anomaly, commonly caused by the congenital absence of elastic and muscular tissue of the sinus aortic wall. This condition often becomes apparent at the time of rupture. The most recently reported case of syncope in unruptured SOVA was due to Tachy-Brady arrhythmia involving the conduction system. This type of aneurysm also presents with signs and symptoms of ventricular outflow tract obstruction, mimicking ventricular tumor. We report a case of recurrent syncope during exertion resulting from SOVA involving the right coronary cusp, without additional symptoms such as angina, malignant arrhythmias, or infection. The mechanisms remain unknown but may be either the consequence of transient left ventricular outflow tract obstruction or cardiac arrhythmia causing syncope during exertion. This case report presents an unusual cause of syncope and demonstrates a correlation between echocardiography and CT angiography images.

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A large aneurysm of a left sinus of Valsalva invading the interventricular septum – a rare cause of syncope

Cited by 8 publications

References 5 publications

Echocardiographic diagnosis of rare pathological patterns of sinus of Valsalva aneurysm

Echocardiographic diagnosis of rare pathological patterns of sinus of Valsalva aneurysm

Sinus of Valsalva Aneurysm—An Unusual Cause of Syncope

An Unusual Cause of Recurrent Syncope: Sinus of Valsalva Aneurysm

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