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Sinus of Valsalva Aneurysm—An Unusual Cause of Syncope

Authors


  • Conflicts of interest: The authors have no conflict of interest.

Address for correspondence and reprint requests: Dr. Manav Sohal, M.R.C.P., M.B.B.S., Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Eastern Road, Brighton BN2 5BE, United Kingdom. Fax: + 44 (0) 1273 984554; E-mail: manavsohal@hotmail.com

Abstract

Sinus of Valsalva aneurysms (SOVA) are rare anomalies which often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient right ventricular outflow tract (RVOT) obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope. SOVA are rare anomalies that often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp, which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient RVOT obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope. (Echocardiography 2010;27:E60-E61)

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