Louis P, Potard D, David M, Portier C, Petit A, Fargeot A, Goguey A, Dentan G, André F, Bouhey J B
Arch Mal Coeur Vaiss. 1986 Jun;79(7):1081-8.
Aneurysms of the sinus of Valsalva are rarely diagnosed before rupture into the cardiac cavities which usually leads to the appearance of a continuous murmur and cardiac failure. In the two cases described, the presenting symptom of the aneurysm was syncope due to cardiac hyperexcitability: ventricular tachycardia in the first and paroxysmal tachyarrhythmia in the second case. The presenting symptoms of unruptured aneurysms of the sinus of Valsalva were analysed. In general, they are: uncontinuous cardiac murmurs: either diastolic murmurs of aortic regurgitation, systolic murmurs of mitral or tricuspid regurgitation, or, as in our first case, of obstruction to right ventricular ejection; arrhythmias: the commonest are conduction defects, which can be syncopal; hyperexcitability (especially ventricular) seems to be very care. Echocardiography is a valuable tool for the diagnosis of sinus of Valsalva aneurysms. The appearances of unruptured aneurysms in our two patients are described. The presence of syncopal cardiac hyperexcitability, possibly associated with one of the preceding auscultatory abnormalities is an indication for echocardiography which may lead to the diagnosis of this condition.
瓦氏窦瘤在破裂进入心腔之前很少被诊断出来，破裂通常会导致连续性杂音和心力衰竭。在所述的两例病例中，瘤体的主要症状是由于心脏过度兴奋引起的晕厥：第一例为室性心动过速，第二例为阵发性快速心律失常。对未破裂的瓦氏窦瘤的主要症状进行了分析。一般来说，这些症状包括：非连续性心脏杂音：要么是主动脉瓣关闭不全的舒张期杂音，二尖瓣或三尖瓣反流的收缩期杂音，或者如我们的第一例病例那样，是右心室射血受阻的杂音；心律失常：最常见的是传导缺陷，可导致晕厥；过度兴奋（尤其是心室）似乎非常罕见。超声心动图是诊断瓦氏窦瘤的重要工具。描述了我们两名患者未破裂瘤体的表现。晕厥性心脏过度兴奋的存在，可能与之前的听诊异常之一相关，是进行超声心动图检查的指征，这可能会导致对这种疾病的诊断。
