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Case Reports
. 2013 Mar 25:2013:bcr2012007855.
doi: 10.1136/bcr-2012-007855.

Ruptured sinus of Valsalva aneurysm from left coronary sinus into right atrium: a rare anomaly with an odd presentation

Ramalingam Vadivelu  1 , Manoj Kumar Rohit, Mukesh Yadav
Affiliations
Case Reports

Ruptured sinus of Valsalva aneurysm from left coronary sinus into right atrium: a rare anomaly with an odd presentation

Ramalingam Vadivelu et al. BMJ Case Rep. .

Abstract

We report a case of a 42-year-old man presenting with shortness of breath and palpitation on exertion, who was evaluated to have left sinus of Valsalva aneurysm rupturing into right atrium. This is a very rare congenital cardiac anomaly with variable clinical presentation ranging from asymptomatic detection on imaging to acute coronary syndrome and sudden cardiac death. Rupture is the most dreaded complication and usually manifests as an acute event. Aneurysmal dilation less commonly affects the left sinus and rupture into the right atrium is still rarer and a chronic insidious presentation as in this case is odd.

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Figures

Figure 1
Figure 1
Transesophageal echocardiography showing sinus of Valsalva aneurysm from left coronary sinus rupturing into right atrium. LA, left atrium; RA, right atrium; LSVA, left sinus of Valsalva aneurysm rupturing into right atrium.
Figure 2
Figure 2
Colour Doppler imaging showing ruptured sinus of Valsalva aneurysm from left coronary sinus opening into right atrium. LA, left atrium; RA, right atrium; LSVA, left sinus of Valsalva aneurysm rupturing into right atrium.
Figure 3
Figure 3
Angiographic picture showing left sinus of Valsalva aneurysm rupturing into right atrium. 1, Left coronary sinus aneurysm; 2, fistulous tract between aneurysmal sac and right atrium; 3, ruptured sinus of Valsalva aneurysm opening into right atrium; 4, right coronary artery.
Figure 4
Figure 4
Left main coronary artery arising from the aneurysmal sac. 1, Left main coronary artery; 2, left coronary sinus aneurysm.
See this image and copyright information in PMC

References

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