Unruptured sinus of Valsalva aneurysms manifesting as complete heart block

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Imaging

Background:

• Sinus of Valsalva aneurysms are rare congenital or acquired dilations of the aortic root.
• Bilateral involvement of both the left and right coronary sinuses is exceptionally uncommon.
• Unruptured aneurysms may remain asymptomatic or cause symptoms due to mass effect or compression.

Observation:

• A patient presented with bilateral, unruptured sinus of Valsalva aneurysms.
• The aneurysm originating from the left coronary sinus significantly protruded into the left atrium.
• The aneurysm from the right coronary sinus extended into the interventricular septum.

Findings:

• The mass effect of the aneurysms caused significant cardiac structural abnormalities.
• The extension of the right sinus aneurysm into the interventricular septum led to transient complete heart block.
• No rupture of the aneurysms was noted at the time of presentation.

Implications:

• This case highlights the potential for significant cardiac complications from unruptured sinus of Valsalva aneurysms.
• Accurate imaging and anatomical understanding are crucial for managing complex cardiovascular anomalies.
• Prompt diagnosis and management are essential to prevent potentially life-threatening events such as heart block or rupture.