Document Detail


Unruptured aneurysm of the left sinus of Valsalva extending into the left ventricular outflow tract: presentation and imaging.
MedLine Citation:
PMID:  9813568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The symptomatic presentation of an unruptured sinus of Valsalva aneurysm is rare. A 48 year old man with a history of treated hypothyroidism, and a five year history of ileocolonic Crohn's disease of chronic low grade activity presented with a profound left hemiplegia. He was in sinus rhythm and normotensive. Cardiac auscultation was repeatedly normal. Computed tomography of the head performed early in the course of the illness was reported as normal. Duplex Doppler examination of the carotid arteries performed six months later revealed no significant atheroma. There was complete resolution of the neurological deficit over a period of months. A year later he presented with chest pain suggestive of myocardial ischaemia. Computed tomography, magnetic resonance imaging, transthoracic and transoesophageal echocardiography, and cardiac catheterisation pointed to a sinus of Valsalva aneurysm protruding into the left ventricular outflow tract. In view of the previous neurological event and ongoing chest pain suggestive of myocardial ischaemia, the lesion was resected. The patient made a good recovery and postoperative transoesophageal echocardiography showed normal aortic valve function with no residual regurgitation. This is the first reported case of pure left ventricular outflow tract extension of an unruptured left sinus aneurysm. The presentation with ischaemic cardiac pain does not seem to be explained by conventional mechanisms.
Authors:
C Pepper; C Munsch; U M Sivananthan; M Pye
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  80     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-11-18     Completed Date:  1998-11-18     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  190-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, York District Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm / complications,  diagnosis,  pathology*
Aortography
Chest Pain / etiology,  pathology
Echocardiography, Transesophageal
Hemiplegia / etiology,  pathology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Sinus of Valsalva / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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