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Sinus of Valsalva Aneurysm

Sinus of Valsalva aneurysms are clinically silent unless they produce symptoms due to compression of adjacent structures or rupture causing an abnormal track of blood flow. Usually they rupture into the right sided chambers so that it constitutes a left to right shunt. Majority of them, over two thirds, arise from the right sinus while some may arise from the non coronary sinus and very few (less than five percent) arise from the left sinus. Sinus of Valsalva aneurysms may be associated with ventricular septal defects, usually of the outlet (subpulmonic) or supracristal variety. Aortic regurgitation may be also associated in up to half of the cases. Progressive increase in the left to right shunt after rupture can cause heart failure and even mortality. Clinical findings will depend on the chamber into which it ruptures. Rupture into right sided chambers cause a superficial continuous murmur. Diastolic augmentation of the continuous murmur is characteristic of rupture into the right ventricle. This is because the track gets compressed in systole and the flow is better in diastole. Sinus of Valsalva aneurysm presents a ‘windsock’ appearance on echocardiography. Even though earlier the treatment of a ruptured sinus of Valsalva aneurysm was entirely surgical, device closure is the norm in most cases now a days. Web: https://johnsonfrancis.org/profession...