Fatal myocardial ischemia caused by compression of the left coronary system by a large left sinus of Valsalva aneurysm

Myocardial ischemia due to compression of an unruptured thoracic aortic aneurysm in a patient with Marfan syndrome

“…In the literature, only three cases showed myocardial infarction due to aneurysmal compression. [4][5][6] In these reports, all of the patients had myocardial infarction of the left main coronary artery, and emergent surgery was undertaken, unlike in our case. [4][5][6] To our knowledge, ours is the fi rst case in which a patient could be correctly diagnosed as having ischemia of the RCA due to aneurysmal compression that was successfully treated before the onset of serious myocardial infarction.…”

Myocardial ischemia resulting from spontaneous dissection in a patient with massive bilateral sinus of valsalva aneurysms

“…Myocardial ischemia is more often associated with aneurysms involving the left sinus [17][18][19][20][21][22][23][24]. Reported causes of myocardial ischemia include occlusion of the coronary ostium and/or embolization into the coronary artery by vegetation or thrombus, external compression of the coronary artery (usually the left), and ostial deformation of the coronary artery [5,[17][18][19][20][21][22][23][24]. Ischemia is often manifest as angina, which is poorly responsive to medical therapy.…”

“…Ischemia is often manifest as angina, which is poorly responsive to medical therapy. Myocardial infarction or sudden death may occur [20,23,24]. Outcomes in patients with ischemia secondary to SVA are poor.…”

Die Ruptur eines kongenitalen rechtskoronaren Sinus-Valsalva-Aneurysmas als Ursache einer akuten kardialen Dekompensation

“…Bei Größenzunahme des Aneurysmas können aber die Patienten auch vor einer Ruptur durch Thoraxschmerzen, bei Kompression oder Verschluß eines Koronarostiums durch eine Angina pectoris, ventrikuläre Tachykardien, einen Myokardinfarkt, einen plötz-lichen Herztod oder durch die Obstruktion des rechtsventrikulären Ausflußtraktes symptomatisch werden (3,7,10,13,16,22,23). Die klinische Erstmanifestation kann auch ein embolisches Ereignis mit dem Aneurysma als Emboliequelle, zunehmende Dyspnoe bei einer Aortenklappeninsuffizienz, eine Endokarditis oder eine mediastinale Raumforderung im Thoraxröntgen sein (18,21,26).…”