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

Cystic medial necrosis: pathological findings and clinical implications

“…Growth hormone excess can be associated with excess mucopolysaccharide deposition characteristic by both CMN and extensive myxomatous degeneration, which even invading all four cardiac valves [44]. CMN can be the underlying cause of heterogeneous Marfan's syndrome [48,49], aneurysm of the circumflex coronary artery [50], spontaneous dissection of the internal thoracic artery [49], aortic valve commissure tear [51], spontaneous dissection of massive bilateral sinus of Valsalva aneurysms [52], pulmonary artery aneurysm [53], and carotid artery aneurysm [20]. Aortic root aneurysm due to donor CMN after heart-lung transplantation was also noted [54].…”