瓦氏窦瘤破裂：年轻成人心力衰竭的隐匿性罕见病因
Ruptured Sinus of Valsalva Aneurysm: Silent and Rare Cause of Heart Failure in Young Adults.
作者信息
Endo Toyokazu, Metz Emily, Crane Joshua, Samson Rohan, Moore Stephanie, Suri Sarabjeet, Fu Sheng, Slaughter Mark S, Pahwa Siddharth V
机构信息
Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA.
University of Louisville School of Medicine, Louisville, Kentucky, USA.
出版信息
JACC Case Rep. 2025 Aug 6;30(22):104566. doi: 10.1016/j.jaccas.2025.104566.
BACKGROUND
Sinus of Valsalva aneurysm is a rare condition that can cause acute heart failure once it develops a fistula.
CASE SUMMARY
A previously healthy 28-year-old man without history of intravenous drug use initially presents with an acute onset of heart failure symptoms. Transthoracic echocardiogram transesophageal echocardiogram revealed an aorto-atrial fistula causing significant left-to-right shunting. Blood cultures were negative for any infectious process. The patient initially required critical care with inotropic support and aggressive diuresis before going to the operating room for definitive repair. Intraoperative findings were consistent with the right sinus of Valsalva windsock deformity.
DISCUSSION
Fistula formation from a ruptured sinus of Valsalva aneurysm is a rare cause of acute heart failure in young adults. However, all other causes should be ruled out, including endocarditis.
TAKE-HOME MESSAGE: In the setting of young, previously healthy adults, ruptured sinus of Valsalva is a rare but silent cause of acute-onset heart failure.
背景
瓦氏窦瘤是一种罕见疾病，一旦形成瘘管可导致急性心力衰竭。
病例摘要
一名既往健康、无静脉药物使用史的28岁男性最初出现急性心力衰竭症状。经胸超声心动图和经食管超声心动图显示存在主动脉-心房瘘，导致明显的左向右分流。血培养未发现任何感染过程。患者最初需要在重症监护下接受正性肌力支持和积极利尿治疗，然后再前往手术室进行确定性修复。术中发现与瓦氏窦右窦风袋样畸形相符。
讨论
瓦氏窦瘤破裂形成瘘管是年轻成年人急性心力衰竭的罕见原因。然而，应排除所有其他原因，包括心内膜炎。
要点
在年轻、既往健康的成年人中，瓦氏窦破裂是急性心力衰竭的罕见但隐匿的原因。
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