Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Case Study
  • Published:

Ruptured sinus of Valsalva aneurysm presenting as ST-elevation myocardial infarction

Nature Reviews Cardiology volume 6, pages 379–382 (2009)Cite this article

Abstract

Background. A 52-year-old man presented with central chest pain, which he had experienced for 8 h. He had no other associated symptoms and no prior history of cardiovascular disease.

Investigations. Electrocardiography, chest radiography, coronary angiography, aortic angiography, echocardiography, CT thorax with contrast.

Diagnosis. Ruptured aneurysm of the sinus of Valsalva.

Management. Emergency sternotomy and pericardiotomy, followed by aortic root replacement.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Initial electrocardiogram demonstrating ST-elevation in leads V1–V3, suggestive of myocardial infarction.
Figure 2: Large aneurysmal dilatation of the aorta at the right sinus of Valsalva.
Figure 3: CT of the mediastinum.
Figure 4: Replacement of aortic root by a modified Bentall procedure after deformation by the partially ruptured and sealed off aneurysm.

References

  1. Hope, J. A Treatise on the Diseases of the Heart and Great Vessels 3rd edn (Churchill & Sons, London, 1839).

    Google Scholar 

  2. Takach, T. J. et al. Sinus of Valsalva aneurysm or fistula: management and outcome. Ann. Thorac. Surg. 68, 1573–1577 (1999).

    Article  CAS  Google Scholar 

  3. Chu, S. H. et al. Ruptured aneurysms of the sinus of Valsalva in Oriental patients. J. Thorac. Cardiovasc. Surg. 99, 288–298 (1990).

    CAS  PubMed  Google Scholar 

  4. Lijoi, A. et al. Unruptured aneurysm of the left sinus of valsalva causing coronary insufficiency: case report and review of the literature. Tex. Heart Inst. J. 29, 40–44 (2002).

    PubMed  PubMed Central  Google Scholar 

  5. Feldman, D. N. & Roman, M. J. Aneurysms of the sinuses of Valsalva. Cardiology 106, 73–81 (2006).

    Article  Google Scholar 

  6. Taguchi, K., Sasaki, N., Matsuura, Y. & Uemura, R. Surgical correction of aneurysm of the sinus of Valsalva. A report of forty-five consecutive patients including eight with total replacement of the aortic valve. Am. J. Cardiol. 23, 180–191 (1969).

    Article  CAS  Google Scholar 

  7. Grollier, G. et al. ST segment elevation in anterior precordial leads and right ventricular infarction. Apropos of 6 cases [French]. Arch. Mal. Coeur. Vaiss. 85, 67–75 (1992).

    CAS  PubMed  Google Scholar 

  8. Inoue, K. et al. Pure right ventricular infarction. Circ. J. 66, 213–215 (2002).

    Article  Google Scholar 

  9. Ott, D. A. Aneurysm of the sinus of valsalva. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 165–176 (2006).

    Article  Google Scholar 

  10. Au, W. K. et al. Repair of ruptured sinus of valsalva aneurysm: determinants of long-term survival. Ann. Thorac. Surg. 66, 1604–1610 (1998).

    Article  CAS  Google Scholar 

  11. van Son, J. A. et al. Long-term outcome of surgical repair of ruptured sinus of Valsalva aneurysm. Circulation 90, II20–II29 (1994).

    CAS  PubMed  Google Scholar 

  12. Arora, R. et al. Transcatheter closure of ruptured sinus of valsalva aneurysm. J. Interv. Cardiol. 17, 53–58 (2004).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Harefield Hospital, Harefield, Middlesex, UK

    Alistair C. Lindsay, Balakrishnan Mahesh, Jullien A. Gaer & Miles C. D. Dalby

Authors
  1. Alistair C. Lindsay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Balakrishnan Mahesh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jullien A. Gaer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Miles C. D. Dalby
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miles C. D. Dalby.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lindsay, A., Mahesh, B., Gaer, J. et al. Ruptured sinus of Valsalva aneurysm presenting as ST-elevation myocardial infarction. Nat Rev Cardiol 6, 379–382 (2009). https://doi.org/10.1038/nrcardio.2009.45

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2009.45

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing