Meel Ruchika, Nethononda Richard, Peters Ferande, Essop Mohammed
Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa. Email:
Division of Cardiology, Chris Hani Baragwanath Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa.
Cardiovasc J Afr. 2017;28(6):e1-e3. doi: 10.5830/CVJA-2017-027. Epub 2017 Jun 29.
Sub-aortic (SA) aneurysms are a rare entity of variable aetiology. We report the first case of a SA aneurysm assessed using cardiac magnetic resonance imaging (MRI). A 33-year-old female with human immunodeficiency virus and on highly active antiretroviral treatment presented with syncope and dyspnoea. Clinical examination suggested moderate to severe aortic regurgitation (AR) confirmed by transthoracic and transoesophageal echocardiograms. However, echocardiography was suboptimal in defining the precise mechanism and severity of AR. A cardiac MRI was done to elucidate the aetiology, severity and mechanism of regurgitation. It confirmed the presence of a SA aneurysm below the left coronary cusp and its retraction, resulting in an eccentric AR jet. An assessment of moderate AR, based on regurgitant volume, was made. Furthermore, the anatomical relationships of the aneurysm were clearly defined. Cardiac MRI allowed comprehensive assessment of this SA aneurysm.
主动脉瓣下（SA）动脉瘤是一种病因多样的罕见疾病。我们报告首例使用心脏磁共振成像（MRI）评估的SA动脉瘤病例。一名33岁感染人类免疫缺陷病毒且正在接受高效抗逆转录病毒治疗的女性出现晕厥和呼吸困难。临床检查提示中度至重度主动脉瓣反流（AR），经胸和经食管超声心动图证实。然而，超声心动图在明确AR的精确机制和严重程度方面并不理想。进行心脏MRI以阐明反流的病因、严重程度和机制。它证实了左冠状动脉瓣下方存在SA动脉瘤及其回缩，导致偏心性AR射流。基于反流容积对中度AR进行了评估。此外，还明确界定了动脉瘤的解剖关系。心脏MRI能够对该SA动脉瘤进行全面评估。
