Huge Sinus of
Valsalva Aneurysm in Patient with Cystic Medial Necrosis of the Aorta
Toušek P.1, Krupička J.1, Línková H.1, Straka Z.2, Koldová L.3, Widimský P.1
1III.interní-kardiologická klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Petr Widimský, DrSc. 2Kardiochirurgická klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta doc. MUDr. Zbyněk Straka, CSc. 3Ústav patologie 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Václav Mandys, CSc. |
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Summary:
In this case we present a patient with unruptured non-coronary sinus of Valsalva aneurysm
associated with diverse clinical findings, caused by acquired degenerative changes of the aortic
wall. A previously healthy 36-year-old female was admitted to the neurological clinic of our hospital
having suffered from an episode of unconsciousness prior to admission, with accompanying
seizures. For the preceding two months she had also been suffering from dyspnoea and palpitation.
Neurological examination, computed tomography of the head and electroencephalography
were with normal findings. Thereafter, due to paroxysm of supraventricular tachycardia she was
referred to cardiology clinic. On routine physical examination a diastolic murmur was detected
and the patient was referred for transthoracic echocardiography. This examination revealed
a large, unruptured noncoronary sinus of Valsalva aneurysm, which was thereafter confirmed by
transoesophageal echocardiography a angiography. The patient was indicated for surgical correction
with aortic valve and aortic root replacement by Bentall procedure. Histological examination
of the part of resected aneurysm found cystic medial degeneration of the aortic wall, also called
cystic medial necrosis.
Key words:
Valsalva sinus aneurysm - Clinical findings - Cystic medial necrosis
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