Author + information
- Received April 27, 2010
- Accepted May 10, 2010
- Published online January 11, 2011.
- Bogdan A. Popescu, MD, PhD⁎,†,
- Denisa Muraru, MD†,
- Carmen Cristiana Beladan, MD⁎,†,
- Ioana Smărăndiţa Lăcău, MD, PhD‡ and
- Carmen Ginghină, MD, PhD⁎,†
An 80-year-old man presented with dyspnea on exertion and systemic congestion. Electrocardiography showed very prolonged first-degree atrioventricular block (PR interval: 480 ms). Transthoracic echocardiography revealed a very large mass at the atrial septal level, occupying most of the atrial cavities (Online Video 1), with normal left ventricle (LV) function. A giant aneurysm of the noncoronary sinus of Valsalva (9.4 × 6.7 cm) with dense spontaneous echo contrast was identified at transesophageal echocardiography (A and B, Online Videos 2 and 3) and cardiac magnetic resonance imaging (D, Online Video 4). A communication flow between the noncoronary sinus of Valsalva and the LV outflow tract and mild aortic and moderate diastolic mitral regurgitation (C, red, green, and yellow arrows, respectively; Online Video 5) were also present. The patient refused surgery and was treated conservatively. To our knowledge, this is the largest sinus of Valsalva aneurysm ever reported, incidentally diagnosed as a “common” presentation in the elderly (atrioventricular block and heart failure). RV = right ventricle.
- Received April 27, 2010.
- Accepted May 10, 2010.
- American College of Cardiology Foundation