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      Chest Pain after Aortic Valve Replacement: Rupture of Right Sinus of Valsalva Presenting as Myocardial Infarction

      case-report

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: A 47-year-old male presented with retrosternal chest pain, which had started 4 days previously and had become excruciating for the past 6 h. He had undergone mechanical aortic valve replacement surgery 4 months previously. Investigation: Electrocardiography, echocardiography, computed tomography-angiography of the aorta. Diagnosis: Rupture of the right sinus of Valsalva and right coronary artery dissection. Management: The defect in the right coronary sinus was closed, and the dissection at the root of the right coronary artery was resected and the right coronary artery bypassed to the root of the aorta.

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          Aneurysms of the Sinuses of Valsalva

          Dmitriy N Feldman, Mary Roman (2006)
          Sinus of Valsalva aneurysms are rare cardiac anomalies which may be acquired or congenital, most commonly involving the right or noncoronary sinuses. The congenital aneurysms are more common and often caused by weakness at the junction of the aortic media and the annulus fibrosus. Acquired aneurysms are caused by conditions affecting the aortic wall, such as infections (syphilis, bacterial endocarditis, or tuberculosis), trauma, or connective tissue disorders. Unruptured aneurysms are usually found incidentally during diagnostic studies. More commonly, sinus of Valsalvaaneurysms are diagnosed after clinical sequelae of rupture. Diagnosis of sinus of Valsalva aneurysm is facilitated by echocardiography, contrast aortography, and more recently, magnetic resonance imaging. Repair is generally required for ruptured aneurysms; unruptured aneurysms encroaching on nearby structures, causing myocardial ischemia, or having the potential to rupture warrant repair. A review of the literature is presented focusing on anatomy, clinical presentation of ruptured and unruptured aneurysms, noninvasive diagnostic modalities, and techniques for repair of this anomaly.
          Article 0 comments Cited 53 times – based on 0 reviews     Review now
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            Sinus of Valsalva aneurysms.

            N Goldberg, N KRASNOW (1990)
            Sinus of Valsalva aneurysms are rare cardiac anomalies which may be acquired or congenital. The congenital aneurysm is more common than the acquired form, with an incidence ranging from 0.1 to 3.5% of all congenital heart defects. Acquired aneurysms may result from trauma, endocarditis, syphilis, Marfan's syndrome, and senile-type dilatation in which the three sinuses dilate as a result of the normal aging process. This review focuses on both congenital and acquired aneurysms with particular attention to the noninvasive diagnosis of this anomaly.
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              Resuscitated sudden cardiac death caused by left main coronary artery compression by an aneurysm of the sinus of Valsalva.

              Wladmir J. Alonso, Miguel Ramírez, F Rincon (2007)
              Article 0 comments Cited 2 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): CRD
                Journal ID (nlm-ta): Cardiology
                Journal ID (doi): 10.1159/issn.0008-6312
                Title: Cardiology
                Publisher: S. Karger AG
                ISSN (Print): 0008-6312
                ISSN (Electronic): 1421-9751
                Publication date Subscription-year: 2016
                Publication date (Print): April 2016
                Publication date (Electronic): 02 February 2016
                Volume: 134
                Issue: 1
                Pages: 22-25
                Affiliations
                aCardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, and bKey Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, and cPeking Union Medical College Hospital, Beijing, PR China
                Author notes
                *Jianqing She, Cardiovascular Department, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710048 (PR China), E-Mail shejianqing@sina.com
                Article
                Publisher ID: 443266 Other ID: Cardiology 2016;134:22-25
                DOI: 10.1159/000443266
                PubMed ID: 26828944
                SO-VID: f583f623-b3fd-4135-88d0-7a9fed89db74
                Copyright © © 2016 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 05 November 2015
                Date accepted : 08 December 2015
                Page count
                Figures: 3, References: 5, Pages: 4
                Categories
                Subject: Novel Insights from Clinical Experience

                ScienceOpen disciplines: General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Keywords: Myocardial infarction,Coronary insufficiency,Ruptured sinus of Valsalva,Aortic surgery,Intracardiac shunting
                Data availability:
                ScienceOpen disciplines: General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology
                Keywords: Myocardial infarction, Coronary insufficiency, Ruptured sinus of Valsalva, Aortic surgery, Intracardiac shunting

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