Sinus of Valsalva aneurysm: myocardial infarction perpetrator
or silent bystander?

J 2024

Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander?

JEDLIČKA, Martin, Fikrle MICHAL, Roman PANOVSKÝ a Lucia MASÁROVÁ

Základní údaje

Originální název

Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander?

Autoři

JEDLIČKA, Martin, Fikrle MICHAL, Roman PANOVSKÝ a Lucia MASÁROVÁ

Vydání

Cor et Vasa, Česká republika, 2024, 0010-8650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 0.200 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.33678/cor.2023.074

UT WoS

001263873100010

Klíčová slova anglicky

Case report; Embolism; Myocardial infarction; Sinus of Valsalva aneurysm

Příznaky

Recenzováno

Změněno: 5. 11. 2024 14:23, Mgr. Tereza Miškechová

Anotace

V originále

Background: In some cases myocardial infarction is not associated with atherothrombotic coronary artery disease and can be caused by many different mechanisms. One of these situations is a coronary artery embolism. This case report discusses the possibility of coronary embolism from newly diagnosed sinus of Valsalva aneurysm (SOVA), which is a rare clinical abnormality that can be clinically silent or symptomatic in varied ways. Case presentation: A 54 -year -old woman presented with ST -segment elevations myocardial infarction of left ventricle inferior wall. We performed emergent coronary angiography where occlusion of the posterior descending artery was established. This finding was according to the interventional cardiologist's suspicion of embolic etiology. Primary percutaneous coronary intervention was performed. Transthoracic echocardiography suspected of an aneurysm of the right sinus of Valsalva presence. We added coronary computed tomography angiography with confirmation of the SOVA with no thrombi inside. Cardiac surgery with a pericardial patch was performed to solve the SOVA. Unfortunately later postpericardiotomy syndrome appeared which was confirmed by cardiac magnetic resonance. We initiated the therapy of pericarditis with a good effect on the patient's clinical state. Discussion: In this case angiographic suspicion for coronary embolism in association with newly diagnosed sinus of Valsalva aneurysm led us to consider SOVA as the origin of the embolus. There have been four cases of systemic embolism from SOVA in so far published data mentioned, but no case of embolism from SOVA to coronary circulation has been described. Probability of the embolus origin from SOVA in this case is increased by localization of SOVA beneath the right coronary artery ostium even if we have no evidence of thrombi inside of SOVA. Because there are no official guidelines of SOVA management and there is no stratifi cation scheme of potential SOVA thrombogenicity, there remains a large space for discussion. SOVA thrombogenicity criteria could be a subject for future research. This is the first published case of presumed coronary embolism from SOVA.

Návaznosti

MUNI/A/1410/2022, interní kód MU

Název: Nové trendy v diagnostice a managementu srdečních onemocnění

Investor: Masarykova univerzita, Nové trendy v diagnostice a managementu srdečních onemocnění

Citovat

JEDLIČKA, Martin, Fikrle MICHAL, Roman PANOVSKÝ a Lucia MASÁROVÁ. Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander? Cor et Vasa. Česká republika, 2024, roč. 66, č. 3, s. 366-369. ISSN 0010-8650. Dostupné z: https://dx.doi.org/10.33678/cor.2023.074.

@article{2338078,
   author = {Jedlička, Martin and Michal, Fikrle and Panovský, Roman and Masárová, Lucia},
   article_location = {Česká republika},
   article_number = {3},
   doi = {http://dx.doi.org/10.33678/cor.2023.074},
   keywords = {Case report; Embolism; Myocardial infarction; Sinus of Valsalva aneurysm},
   language = {eng},
   issn = {0010-8650},
   journal = {Cor et Vasa},
   note = {Bez afiliace k MU.},
   title = {Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander?},
   url = {https://e-coretvasa.cz/artkey/cor-202403-0010_sinus-of-valsalva-aneurysm-myocardial-infarction-perpetrator-or-silent-bystander.php},
   volume = {66},
   year = {2024}
}

TY  - JOUR
ID  - 2338078
AU  - Jedlička, Martin - Michal, Fikrle - Panovský, Roman - Masárová, Lucia
PY  - 2024
TI  - Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander?
JF  - Cor et Vasa
VL  - 66
IS  - 3
SP  - 366-369
EP  - 366-369
SN  - 00108650
N1  - Bez afiliace k MU.
KW  - Case report
KW  - Embolism
KW  - Myocardial infarction
KW  - Sinus of Valsalva aneurysm
UR  - https://e-coretvasa.cz/artkey/cor-202403-0010_sinus-of-valsalva-aneurysm-myocardial-infarction-perpetrator-or-silent-bystander.php
N2  - Background: In some cases myocardial infarction is not associated with atherothrombotic coronary artery disease and can be caused by many different mechanisms. One of these situations is a coronary artery embolism. This case report discusses the possibility of coronary embolism from newly diagnosed sinus of Valsalva aneurysm (SOVA), which is a rare clinical abnormality that can be clinically silent or symptomatic in varied ways. Case presentation: A 54 -year -old woman presented with ST -segment elevations myocardial infarction of left ventricle inferior wall. We performed emergent coronary angiography where occlusion of the posterior descending artery was established. This finding was according to the interventional cardiologist's suspicion of embolic etiology. Primary percutaneous coronary intervention was performed. Transthoracic echocardiography suspected of an aneurysm of the right sinus of Valsalva presence. We added coronary computed tomography angiography with confirmation of the SOVA with no thrombi inside. Cardiac surgery with a pericardial patch was performed to solve the SOVA. Unfortunately later postpericardiotomy syndrome appeared which was confirmed by cardiac magnetic resonance. We initiated the therapy of pericarditis with a good effect on the patient's clinical state. Discussion: In this case angiographic suspicion for coronary embolism in association with newly diagnosed sinus of Valsalva aneurysm led us to consider SOVA as the origin of the embolus. There have been four cases of systemic embolism from SOVA in so far published data mentioned, but no case of embolism from SOVA to coronary circulation has been described. Probability of the embolus origin from SOVA in this case is increased by localization of SOVA beneath the right coronary artery ostium even if we have no evidence of thrombi inside of SOVA. Because there are no official guidelines of SOVA management and there is no stratifi cation scheme of potential SOVA thrombogenicity, there remains a large space for discussion. SOVA thrombogenicity criteria could be a subject for future research. This is the first published case of presumed coronary embolism from SOVA.
ER  -

JEDLIČKA, Martin, Fikrle MICHAL, Roman PANOVSKÝ a Lucia MASÁROVÁ. Sinus of Valsalva aneurysm: myocardial infarction perpetrator or silent bystander? \textit{Cor et Vasa}. Česká republika, 2024, roč.~66, č.~3, s.~366-369. ISSN~0010-8650. Dostupné z: https://dx.doi.org/10.33678/cor.2023.074.

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