Ruptured sinus of Valsalva aneurysm from left coronary sinus into right atrium: a rare anomaly with an odd presentation

Severe Dilatation of Coronary Artery Ostium Complicating Sinus of Valsalva Aneurysm: Differential Diagnosis and Review of the Literature

Coronary artery dilatation may be due to various aetiologies including congenital anomalies, atherosclerotic coronary disease, and Kawasakis disease. We describe a case characterised by apparent severe dilatation of the right coronary artery ostium in an asymptomatic male. Subsequent imaging and surgical intervention documented the presence of a sinus of Valsalva aneurysm extending into the ostium of the right coronary artery. This represents an unusual manifestation of a sinus of Valsalva aneurysm. The underlying pathophysiology, differential diagnosis, role of surgical management, and outcomes are discussed.

Congenital Aneurysm of the Left Sinus of Valsalva Involving the Left Main Coronary Artery

Successful surgical management of a case of congenital aneurysm of the left sinus of Valsalva involving the left main coronary artery has been reported. To our knowledge, this is the first report describing an unusual case of congenital aneurysm of the left sinus of Valsalva, which involves the left main coronary artery.

The dilemma of evaluating a continuous murmur in a patient of aneurysm of sinus of Valsalva and coronary cameral fistula presenting with supraventricular tachycardia

A 39-year-old hypothyroid woman on thyroxine replacement therapy presented with an unresolving episode of palpitations (narrow-complex tachycardia). Clinical examination, after reversion to normal sinus rhythm revealed a precordial continuous murmur. Initial transthoracic echocardiogram showed an unruptured aneurysm of left sinus of Valsalva (LSOV), however, because a continuous murmur could not be explained by this condition, a repeat colour Doppler study was made, revealing a communicating tract from the left main coronary artery (LMCA) and terminating in the right atrium (RA). A transesophageal echocardiogram revealed an aneurysmal LMCA and LSOV, with similar colour Doppler findings. A further CT scan and coronary angiogram confirmed a coronary cameral fistula opening into RA. In conclusion, the relevance of a diligent clinical examination and imaging after conversion to normal sinus rhythm in picking up such anomalies cannot be over-emphasised, as previous routine echocardiograms on the same patient had been reported as normal.