Hwang Ji-Won
Division of Cardiology, Department of Medicine, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Republic of Korea.
J Cardiol Cases. 2020 Jun 29;22(4):192-194. doi: 10.1016/j.jccase.2020.06.006. eCollection 2020 Oct.
A 24-year-old male patient presented with symptoms of acute progressive dyspnea and chest pain. Transthoracic echocardiography demonstrated a mobile mass-like lesion attached to the tricuspid valve, as well as a holodiastolic flow reversal in the descending and abdominal aorta, as increased retrograde flow. We also evaluated the vegetation-like lesion by transesophageal echocardiography. As a result, we were able to diagnose the rupture of the sinus of Valsalva with shunt flow between the aorta and the right heart that had manifested as sudden chest pain and acute dyspnea. The patient underwent surgical repair for this ruptured lesion. After surgery, there was no evidence of residual shunt flow. The objective of this report is to describe a rare presentation of a ruptured sinus of Valsalva and to discuss the importance of adequate diagnosis using advanced imaging modalities. < If the rupture of sinus of Valsalva remains untreated, prognosis could be poor. Prompt diagnosis and timely surgical correction are important, as is further evaluation by transesophageal echocardiography imaging, which could be mandatory for adequate diagnosis.>.
一名24岁男性患者出现急性进行性呼吸困难和胸痛症状。经胸超声心动图显示一个附着于三尖瓣的活动的肿块样病变，以及降主动脉和腹主动脉全舒张期血流逆转，即逆行血流增加。我们还通过经食管超声心动图评估了赘生物样病变。结果，我们得以诊断出瓦氏窦破裂，伴有主动脉与右心之间的分流，表现为突发胸痛和急性呼吸困难。该患者接受了针对此破裂病变的手术修复。术后，没有残余分流的证据。本报告的目的是描述瓦氏窦破裂的罕见表现，并讨论使用先进成像方式进行充分诊断的重要性。<如果瓦氏窦破裂未得到治疗，预后可能很差。及时诊断和及时手术矫正很重要，经食管超声心动图成像的进一步评估也很重要，这对于充分诊断可能是必不可少的。>
