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Case Reports
. 2012 Sep;17(3):148-9.

An uncommon cause of a continuous murmur

Bernard Topi  1 , Jinu John, Amit Agarwal, Nishant Nerella, Vijay Shetty, Adnan Sadiq, Jacob Shani
Affiliations
Case Reports

An uncommon cause of a continuous murmur

Bernard Topi et al. Exp Clin Cardiol. 2012 Sep.

Abstract

Aneurysms of the sinus of Valsalva are rare congenital lesions. Less often, they are encountered secondary to trauma, infective endocarditis or syphilis. The majority of these aneurysms arise from the right coronary sinus. The present report describes a rare case of an aneurysm arising from the noncoronary sinus of Valsalva and rupturing into the right atrium. Patients with unruptured aneurysms often remain asymptomatic. Rupture of the aneurysm usually causes the appearance of a continuous murmur in the left sternal border. Common sites of rupture include the right ventricle, right atrium or left atrium. Surgical repair is usually associated with a favourable outcome.

Keywords: Congenital heart disease; Continuous murmur; Hypertension; Sinus of Valsalva aneurysm.

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Figures

Figure 1)
Figure 1)
Transesophageal echocardiogram. Midesophageal, two-dimensional short-axis view showing a sinus of Valsalva aneurysm (arrows) arising from the noncoronary sinus (NCS) and bulging into right atrium (RA). LA Left atrium
Figure 2)
Figure 2)
Transesophageal echocardiogram. Transgastric long-axis view showing a sinus of Valsalva aneurysm (arrows) with a characteristic ‘wind-sock’ appearance arising from the aortic root. RA Right atrium; RV Right ventricle
Figure 3)
Figure 3)
Transesophageal echocardiogram. Midesophageal, short-axis view with colour Doppler showing fistulous flow (arrows) from the aorta into the right atrium (RA) through the ruptured sinus of Valsalva aneurysm. LA Left atrium; RV Right ventricle
Figure 4)
Figure 4)
Transesophageal echocardiogram. Transgastric long-axis view with colour Doppler showing aorto-right atrial fistula (arrow) due to rupture of a sinus of Valsalva aneurysm. RA Right atrium; RV Right ventricle
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References

    1. Meier JH, Seward JB, Miller FA, Jr, Oh JK, Enriquez-Sarano M. Aneurysms of the left ventricular outflow tract: Clinical presentation, causes, and echocardiographic features. J Am Soc Echocardiogr. 1998;11:729–45. - PubMed
    1. Takach TJ, Reul GJ, Duncan JM, et al. Sinus of Valsalva aneurysm or fistula: Management and outcome. Ann Thorac Surg. 1999;68:1573–7. - PubMed
    1. Bulkley BH, Hutchins GM, Ross RS. Aortic sinus of Valsalva aneurysms simulating primary right-sided valvular heart disease. Circulation. 1975;52:696–9. - PubMed
    1. Moustafa S, Mookadam F, Cooper L, et al. Sinus of Valsalva aneurysms – 47 years of a single center experience and systematic overview of published reports. Am J Cardiol. 2007;99:1159–64. - PubMed

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