Giant Ruptured Sinus of Valsalva Aneurysm
Patient EAC, female, 33, with previous history of hypertension, presented dyspnea, palpitations, and edema of the lower limbs for about 15 years, with worsening for approximately 10 months and evolving to dyspnea at rest and paroxysmal nocturnal dyspnea in recent days. Cardiac auscultation was irregular heart rhythm with holosystolic murmur (5 +/6 +) continues along the right sternal border.
Laboratory evaluation of the patient showed no significant alterations. However, the electrocardiogram showed a type of arrhythmia incompatible with his age. Therefore, it was decided to do a larger investigation with other imaging tests.
Echocardiography shows a significant increase in cardiac chambers and significant degree of diffuse hypokinesia of the left ventricle FE (Teicholz): 25%. An oval image was observed with pendulous movement swinging the tricuspid valve with a continuity area near the aortic valve and aortic sinuses. This image was incompatible with common diseases of the tricuspid valve. The anatomical defect found invaded the inside of the right chambers, causing failure of tricuspid valve coaptation and a significant degree of failure. The patient underwent a surgical procedure and was followed up. The final outcome of the defect correction and the clinical outcome of the case are motivators for the study of cardiovascular surgery.
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