Sohal Manav, Rajani Ronak, de Belder Adam
Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Eastern Road, Brighton, United Kingdom.
Echocardiography. 2010 Jul;27(6):E60-1. doi: 10.1111/j.1540-8175.2009.01141.x. Epub 2010 Jun 9.
Sinus of Valsalva aneurysms (SOVA) are rare anomalies which often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient right ventricular outflow tract (RVOT) obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope. SOVA are rare anomalies that often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp, which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient RVOT obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope.
瓦氏窦瘤（SOVA）是一种罕见的异常情况，通常仅在破裂时才会显现出来。与未破裂的动脉瘤相关的晕厥是一种已被认识的症状，但在大多数先前报道的病例中，其机制要么是缓慢性心律失常，要么是快速性心律失常。我们报告一例累及右冠状动脉瓣叶的大型SOVA病例，该病例表现为晕厥，继发于低血压，推测是由于短暂性右心室流出道（RVOT）梗阻导致左心房充盈减少所致。该病例展示了超声心动图和血管造影图像如何相互关联，以及一种不寻常的晕厥机制。瓦氏窦瘤是一种罕见的异常情况，通常仅在破裂时才会显现出来。与未破裂的动脉瘤相关的晕厥是一种已被认识的症状，但在大多数先前报道的病例中，其机制要么是缓慢性心律失常，要么是快速性心律失常。我们报告一例累及右冠状动脉瓣叶的大型SOVA病例，该病例表现为晕厥，继发于低血压，推测是由于短暂性RVOT梗阻导致左心房充盈减少所致。该病例展示了超声心动图和血管造影图像如何相互关联，以及一种不寻常的晕厥机制。
