Ruptured sinus of valsalva aneurysm.

Abstract

A 32-year-old female was referred for evaluation of acontinuous murmur heard at the base of the heart with noradiation to the back. She was otherwise healthy, had nocomplaints and did not show signs of congestive heartfailure. She went through two pregnancies withoutcomplications. Her colour Doppler echocardiography(Fig. 1a) showed a communication between the rightcoronary sinus and the right atrium. This was confirmed tobe a ruptured sinus of Valsalva aneurysm (SVA) byascending aortic angiography (Fig. 1b). Subsequently,she was referred for surgical repair.Sinus of Valsalva aneurysm is a rare cardiac abnor-mality, with its aetiology being congenital, due toweakness at the junction between the aortic media andthe annulus fibrosus, or acquired secondary to infectiveendocarditis, syphilitic aortitis atherosclerosis or connec-tive tissue disease [1]. The right coronary sinus is thecommonest site for these aneurysms with the right ventriclebeing the commonest chamber into which they rupture [2].The mainstay of treatment for ruptured SVA is surgicalintervention. Early aggressive management is recommendedto prevent endocarditis or enlargement of the lesion, whichmight necessitate more extensive repair [3].References