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Ruptured sinus of Valsalva.
George Koshy1, Alfred E Farias, Nagi A Moussa
1Division of Cardiology and Department of Medicine, Al Ain Hospital, Al Ain, United Arab Emirates. gkcardio@emirates.net.ae
Saudi Medical Journal
|September 18, 2002
Summary
A young woman with a congenital ventricular septal defect (VSD) experienced acute heart failure due to a ruptured sinus of Valsalva. Surgical repair of the VSD and aortic valve replacement successfully treated her condition.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Case Reports
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Ruptured sinus of Valsalva is a rare but serious complication, often associated with VSD.
- Sudden onset of chest pain and pulmonary edema can indicate acute cardiac events.
Observation:
- A 24-year-old female with a known VSD presented with acute chest pain, palpitations, and pulmonary edema.
- Clinical examination revealed cardiomegaly, a pansystolic murmur of VSD, and a continuous murmur.
- ECG showed ventricular premature beats; chest X-ray confirmed cardiomegaly and pulmonary venous congestion.
Findings:
- Transthoracic echocardiography identified a ruptured non-coronary sinus of Valsalva into the right ventricle with a large left-to-right shunt.
- A perimembranous subaortic VSD with a left-to-right shunt was also diagnosed.
- Associated findings included right coronary cusp prolapse and mild aortic regurgitation, with preserved left ventricular systolic function.
Implications:
- This case highlights the importance of early diagnosis and surgical intervention for complex congenital heart defects.
- Prompt management of ruptured sinus of Valsalva and VSD is crucial to prevent severe complications like heart failure.
- Successful surgical correction can lead to favorable outcomes in patients with combined cardiac anomalies.