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Heart, Lung and Circulation (2015) xx, 1–3 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2015.04.182
Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm Sang-Hyun Park a, Sang-Hoon Seol b*, Guang-Won Seo b, Pil-Sang Song b, Dong-Kie Kim b, Ki-Hun Kim b, Doo-Il Kim b a
Department of Urology, Inje University College of Medicine, Haeundae Paik hospital, Busan, Korea Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik hospital, Busan, Korea
b
Received 8 April 2015; received in revised form 19 April 2015; accepted 22 April 2015; online published-ahead-of-print xxx
Acquired aneurysms of the sinus of Valsalva are rare. They are caused by infections such as tuberculosis, syphilis and endocarditis, as well as atherosclerosis and traumatic injury. They may be asymptomatic and incidentally discovered. We present a rare case of a large acquired calcified unruptured aneurysm of the right coronary sinus of Valsalva that was compressing the right ventricular outflow tract. Keywords
Acquired Aneurysm Calcification Sinus of Valsalva Operation
A 79 year-old woman was referred to our hospital for evaluation of chest pain. Electrocardiogram showed normal findings. Chest PA showed no active lung lesion (Fig. 1). Echocardiography showed aneurysmal dilatation of the right sinus of Valsalva. A large calcified aneurysm compressed the right ventricular outflow tract (Fig. 2). Coronary angiography showed a large aneurysm that originated from the right coronary cusp. There was no significant stenosis of the coronary artery (Fig. 3). Chest CT revealed a large aneurysm with eccentric atheroma or thrombus in the right coronary cusp that was protruding to the right ventricle (maximal diameter of 4.8 cm)(Fig. 4). We recommended operation, however, the patient did not consent. Aneurysms of Valsalva sinus are rare. Acquired aneurysms are caused by degenerative conditions such as atherosclerosis, chest trauma, and infectious diseases [1,2].
Fig. 1 Chest PA revealed normal finding.
*Corresponding author at: Department of Medicine, Inje University College of Medicine, Haundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 612-030, Korea. Tel.: +82 51 797 3070; fax: +82 51 797 3009, Email: [email protected] © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
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Fig. 2 Transthoracic echocardiography showed a huge calcified aneurysm of right coronary cusp.
Fig. 3 Coronary angiography demonstrated a large aneurysm with no stenosis of the coronary artery.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
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Large calcified unruptured sinus of Valsalva aneurysm
Fig. 4 Chest CT revealed a huge aneurysm with atheroma of thrombus compressing to the right ventricle.
Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.hlc. 2015.04.182.
References [1] Fishbein MC, Obma R, Roberts WC. Unruptured sinus of Valsalva aneurysm. The American Journal of Cardiology 1975;35:918–22. [2] Haraphongse M, Ayudhya RK, Jugdutt B, Rossall RE. Isolated unruptured sinus of Valsalva aneurysm producing right ventricular outflow obstruction. Catheterization and Cardiovascular Diagnosis 1990;19:98–102.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
IMAGE
Heart, Lung and Circulation (2015) xx, 1–3 1443-9506/04/$36.00 http://dx.doi.org/10.1016/j.hlc.2015.04.182
Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm Sang-Hyun Park a, Sang-Hoon Seol b*, Guang-Won Seo b, Pil-Sang Song b, Dong-Kie Kim b, Ki-Hun Kim b, Doo-Il Kim b a
Department of Urology, Inje University College of Medicine, Haeundae Paik hospital, Busan, Korea Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik hospital, Busan, Korea
b
Received 8 April 2015; received in revised form 19 April 2015; accepted 22 April 2015; online published-ahead-of-print xxx
Acquired aneurysms of the sinus of Valsalva are rare. They are caused by infections such as tuberculosis, syphilis and endocarditis, as well as atherosclerosis and traumatic injury. They may be asymptomatic and incidentally discovered. We present a rare case of a large acquired calcified unruptured aneurysm of the right coronary sinus of Valsalva that was compressing the right ventricular outflow tract. Keywords
Acquired Aneurysm Calcification Sinus of Valsalva Operation
A 79 year-old woman was referred to our hospital for evaluation of chest pain. Electrocardiogram showed normal findings. Chest PA showed no active lung lesion (Fig. 1). Echocardiography showed aneurysmal dilatation of the right sinus of Valsalva. A large calcified aneurysm compressed the right ventricular outflow tract (Fig. 2). Coronary angiography showed a large aneurysm that originated from the right coronary cusp. There was no significant stenosis of the coronary artery (Fig. 3). Chest CT revealed a large aneurysm with eccentric atheroma or thrombus in the right coronary cusp that was protruding to the right ventricle (maximal diameter of 4.8 cm)(Fig. 4). We recommended operation, however, the patient did not consent. Aneurysms of Valsalva sinus are rare. Acquired aneurysms are caused by degenerative conditions such as atherosclerosis, chest trauma, and infectious diseases [1,2].
Fig. 1 Chest PA revealed normal finding.
*Corresponding author at: Department of Medicine, Inje University College of Medicine, Haundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan, 612-030, Korea. Tel.: +82 51 797 3070; fax: +82 51 797 3009, Email: [email protected] © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
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Fig. 2 Transthoracic echocardiography showed a huge calcified aneurysm of right coronary cusp.
Fig. 3 Coronary angiography demonstrated a large aneurysm with no stenosis of the coronary artery.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
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Large calcified unruptured sinus of Valsalva aneurysm
Fig. 4 Chest CT revealed a huge aneurysm with atheroma of thrombus compressing to the right ventricle.
Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.hlc. 2015.04.182.
References [1] Fishbein MC, Obma R, Roberts WC. Unruptured sinus of Valsalva aneurysm. The American Journal of Cardiology 1975;35:918–22. [2] Haraphongse M, Ayudhya RK, Jugdutt B, Rossall RE. Isolated unruptured sinus of Valsalva aneurysm producing right ventricular outflow obstruction. Catheterization and Cardiovascular Diagnosis 1990;19:98–102.
Please cite this article in press as: Park S-H, et al. Acquired Large Calcified Unruptured Sinus of Valsalva Aneurysm. Heart, Lung and Circulation (2015), http://dx.doi.org/10.1016/j.hlc.2015.04.182
