Sinus of valsalva aneurysm presenting as myocardial infarction during dobutamine stress test

Abstract

We report a patient with an undiagnosed left sinus of Valsalva aneurysm who, during a dobutamine stress test, had myocardial injury and subsequent infarction. Cardiac catheterization revealed an expanding sinus of valsalva aneurysm compressing the circumflex coronary artery. The clinical manifestations of sinus of Valsalva aneurysm are discussed. This report heightens awareness of the possible effects of the pharmacologic stress test. © 1996 Wiley‐Liss, Inc.

Acute Myocardial Infarction Due to Unruptured Aneurysm of Left Sinus of Valsalva with Aortic Valve Regurgitation

“…The unruptured aneurysm is typically symptom free but potentially fatal due to rupture into cardiac chambers, pulmonary artery, or outside the heart. It may be detected as myocardial infarction or ischemia owing to the obstruction or stenosis of the left main coronary artery 3,4 …”

Incidence, Pathophysiology, and Treatment of Complications During Dobutamine-Atropine Stress Echocardiography

“…Dobutamine stress-induced expansion of a sinus of Valsalva aneurysm, with compression of a coronary artery, was once reported as a potential mechanism for MI. 42 Treatment Discontinue dobutamine infusion. Consider thrombolysis or immediate coronary angiography followed by angioplasty.…”

“…Dans une publication, la survenue d'un IDM a été considérée comme possiblement imputable à l'expansion d'un d'anévrisme du sinus de Valsalva, provoquée par une épreuve de stress sous dobutamine. 42 …”

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.…”