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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Embolic Stroke Due to a Large Noncoronary Sinus of Valsalva Aneurysm: A Multimodality Imaging Diagnosis

Tyler C Miller1, Stanley Wolfe2, Dawn Smith1

  • 1Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA.

JACC. Case Reports
|June 27, 2025
PubMed

Insights

A rare sinus of Valsalva aneurysm (SoVA) can present as an embolic stroke. Prompt diagnosis with multimodality imaging and surgical repair led to a patient's full recovery.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Sinus of Valsalva aneurysm (SoVA) is a rare cardiac condition involving coronary sinus dilation.
  • Untreated SoVA can lead to severe complications like valvular dysfunction, arrhythmias, or rupture.

Observation:

  • A 71-year-old patient with hypertension and hyperlipidemia presented with an embolic stroke.
  • Multimodality imaging identified a large SoVA (7.0 cm × 5.6 cm) originating from the noncoronary sinus, causing near-complete left atrial obstruction.

Findings:

  • The patient's stroke was likely caused by thrombus formation within the SoVA, which then embolized.
  • Surgical repair of the SoVA was successfully performed, resulting in the patient's full recovery.

Implications:

  • This case highlights that stroke can be an initial presentation of SoVA.
  • Multimodality imaging is crucial for diagnosing SoVA and planning surgical interventions.
  • Clinicians should include SoVA in the differential diagnosis for patients presenting with stroke.
Abstract

Keywords:
aortic root repaircomputed tomographycoronary angiographymultimodality cardiac imagingnoncoronary sinussinus of Valsalva aneurysmstroketransesophageal echocardiogramtransthoracic echocardiogram

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