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Ruptured Right Sinus of Valsalva Aneurysm to the Right Atrium Mimicking Acute Myocardial Infarction

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초록

We present a rare case involving a ruptured sinus of Valsalva aneurysm (SVA) and acute myocardial infarction in a 39-year-old male patient. Coronary angiography showed normal findings; however, the patient showed remarkably elevated levels of cardiac enzymes and decreased left ventricular function with apical akinesia on transthoracic echocardiography. Transesophageal echocardiography revealed shunt flow from the SVA to the right atrium without significant aortic regurgitation. Preoperative cardiac arrest was managed by cardiopulmonary resuscitation, and surgical repair was performed by closing the entrance of the aneurysm. However, the compromised hemodynamic status was not reversed by surgery.

Abstract

We present a rare case involving a ruptured sinus of Valsalva aneurysm (SVA) and acute myocardial infarction in a 39-year-old male patient. Coronary angiography showed normal findings; however, the patient showed remarkably elevated levels of cardiac enzymes and decreased left ventricular function with apical akinesia on transthoracic echocardiography. Transesophageal echocardiography revealed shunt flow from the SVA to the right atrium without significant aortic regurgitation. Preoperative cardiac arrest was managed by cardiopulmonary resuscitation, and surgical repair was performed by closing the entrance of the aneurysm. However, the compromised hemodynamic status was not reversed by surgery.

참고문헌 (5)

  1. Takach TJ, "Sinus of Valsalva aneurysm or fistula: management and outcome", Ann Thorac Surg, 68, pp.1573~1577 (1999)
  2. Cuculi F, "Rupture of a left sinus of valsalva aneurysm with coronary compression: a rare cause of ischemic chest pain", Ann Thorac Surg, 92, pp.e97~e99 (2011)
  3. Regueiro Abel M, "Sinus of Valsalva aneurysm as a cause of acute myocardial infarction", Rev Esp Cardiol, 55, pp.77~79 (2002)
  4. van Son JA, "Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm", Circulation, 90(5 Pt 2), pp.II20~II29 (1994)
  5. Sasson L, "Ruptured sinus of Valsalva aneurysm complicated by myocardial ischemia: pathogenetic mechanisms", Cardiovasc Pathol, 15, pp.291~293 (2006)

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