Kharwar Rajiv Bharat, Narain Varun Shankar, Sethi Rishi
Department of Cardiology, King Georges' Medical University, Lucknow, Uttar Pradesh, India.
Echocardiography. 2013 Nov;30(10):E331-5. doi: 10.1111/echo.12316. Epub 2013 Aug 10.
Aneurysms arising from the sinus of Valsalva are a rare cardiac defect that can present with various signs and symptoms, and if not diagnosed and treated rapidly can lead to fatal outcomes. Unruptured aneurysms are usually asymptomatic and found incidentally during diagnostic studies. More commonly, aneurysm of sinus of Valsalva is detected after the occurrence of rupture. Echocardiography has become the investigative tool of choice for this condition, not only for diagnosis but also for quantification of severity. We hereby report a rare case of a 15-year-old patient presenting with complaints of effort dyspnea and palpitations. Two-dimensional transthoracic echocardiography (TTE) showed aneurysmal dilatation of left sinus of Valsalva which had ruptured into the left ventricle. Also, there was an intimal flap within the sinus of Valsalva aneurysm. The anatomical relationship between the aorta, aneurysm, and the left ventricle as well as the intimal flap within the aneurysm was clearly delineated with the help of three-dimensional TTE. After confirmation of the diagnosis with multidetector computed tomography, patient underwent successful surgical repair of the defect.
源于主动脉窦的动脉瘤是一种罕见的心脏缺陷，可表现出各种体征和症状，若不迅速诊断和治疗可导致致命后果。未破裂的动脉瘤通常无症状，在诊断性检查时偶然发现。更常见的是，主动脉窦动脉瘤在破裂后被发现。超声心动图已成为这种疾病的首选检查工具，不仅用于诊断，还用于严重程度的量化。我们在此报告一例罕见病例，一名15岁患者主诉劳力性呼吸困难和心悸。二维经胸超声心动图（TTE）显示主动脉左窦瘤样扩张并已破入左心室。此外，主动脉窦瘤内有一个内膜瓣。借助三维TTE清晰地描绘了主动脉、动脉瘤和左心室之间的解剖关系以及动脉瘤内的内膜瓣。在通过多排螺旋计算机断层扫描确诊后，患者成功接受了缺损的手术修复。
