Rupture of sinus of Valsalva aneurysm: Two case reports and a concise review of the literature

Tariq S Marroush; Andrew R Boshara; Bassent Botros; Philip Vendittelli; Zohaib Ahmed; Luay Dawood; Howard S Rosman

doi:10.1016/j.hrtlng.2017.10.005

Rupture of sinus of Valsalva aneurysm: Two case reports and a concise review of the literature

Heart Lung. 2018 Mar-Apr;47(2):131-135. doi: 10.1016/j.hrtlng.2017.10.005. Epub 2017 Nov 22.

Authors

Tariq S Marroush¹, Andrew R Boshara², Bassent Botros³, Philip Vendittelli⁴, Zohaib Ahmed⁵, Luay Dawood⁶, Howard S Rosman⁷

Affiliations

¹ Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Tariqmarroush@hotmail.com.
² Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Andrew.Boshara@ascension.org.
³ Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Bassent.Botros@ascension.org.
⁴ Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Philip.Vendittelli@ascension.org.
⁵ Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Zohaib.Ahmed@ascension.org.
⁶ Department of Internal Medicine, Ascension Health, Saint John Hospital and Medical Center, 19251 Mack Ave Suite 335, Grosse Pointe Woods, Detroit, MI 48236, USA. Electronic address: Luay.Dawood@ascension.org.
⁷ Division of Cardiology, Ascension Health, Saint John Hospital and Medical Center, 22101 Moross Road VEP, 2nd Floor, Cath Lab, Detroit, MI 48236, USA. Electronic address: Howard.Rosman@ascension.org.

PMID: 29174362
DOI: 10.1016/j.hrtlng.2017.10.005

Abstract

Background: The rupture of sinus of Valsalva aneurysm (RSoVA) is a rare disorder that affects the integrity of the cardiovascular system, disrupting its dynamics and resulting in a variety of manifestations. In this report, we discuss two cases of RSoVA that we encountered and review similar cases reported in the literature.

Methods: literature review of reported cases of RSoVA in PubMed and Google Scholar.

Results: A total of 223 cases were found and the final analysis included 225 cases, of which 69% occurred in males and the mean age was 38.9 years. Dyspnea was the most common presenting symptom and 76% of the cases described continuous murmur on examination. The right sinus was affected in 61% of the cases and the fistula connected to the right chambers of the heart 73% of the time.

Conclusion: RSoVA is a rare condition that is difficult to diagnose, it should be considered in the right context, particularly in young patients with symptoms of heart failure and the presence of continuous murmur on cardiac examination.

Keywords: Aneurysm; Cardiac fistula; Rupture; Sinus; Valsalva.

Publication types

Case Reports
Review

MeSH terms

Aortic Aneurysm / complications
Aortic Aneurysm / diagnosis*
Aortic Rupture / complications
Aortic Rupture / diagnosis*
Computed Tomography Angiography
Dyspnea / etiology
Female
Heart Failure / etiology
Heart Murmurs / etiology
Humans
Middle Aged
Physical Examination
Sinus of Valsalva*
Young Adult