Sinus of Valsalva aneurysm

Case contributed by Dr Eric F Greif

Presentation

Having cough and dyspnea intermittently for 3 years.

Patient Data

Age: 39
Gender: Female
Modality: CT

There is a 6.5 x 4.5 cm aneurysm arising from the right coronary cusp of the sinus of Valsalva, immediately below the origin of the right coronary artery. This causes moderate mass effect/compression upon right atrium and ventricle. 

Mild pectus excavatum is present.

Modality: CT

Status post repair of right sinus of Valsalva aneurysm. Mild cardiomegaly with small pericardial effusion. Small left pleural effusion with associated mild left lower lobe passive atalectasis.

Case Discussion

Sinus of Valsalva aneurysm complications include rupture and mass effect on adjacent cardiac structures causing ventricular outflow tract obstruction, compression of a coronary artery leading to myocardial ischemia, and arrhythmias 1.

This patient's complaint of shortness of breath was likely secondary to the aneurysm causing mass effect and relative right ventricular outflow tract obstruction.  The patient in this case went on to have surgical repair as seen above.

Sinus of Valsalva aneurysms can be acquired or congenital (Marfan syndrome or Ehlers–Danlos syndrome) 1. In this case we are unsure how the patient obtained a sinus of Valsalva aneurysm.

ECG gated, contrast-enhanced multisection CT is used to provide better spatial resolution of cardiac structures and detailed anatomy (as used in this case).

 

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Case Information

rID: 32856
Case created: 18th Dec 2014
Last edited: 16th Apr 2017
System: Cardiac
Inclusion in quiz mode: Included

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