SHM Converge Scientific Abstract ePoster Gallery-A Rare and Elusive Aneurysm That Can Be Fatal: A Case of a Ruptured Sinus of Valsalva Aneurysm Causing Multiorgan Failure

A Rare and Elusive Aneurysm That Can Be Fatal: A Case of a Ruptured Sinus of Valsalva Aneurysm Causing Multiorgan Failure

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This case report describes a rare but life-threatening rupture of a sinus of Valsalva aneurysm (SVA), a cardiac abnormality caused by weakness of the aortic root wall. SVAs are often silent until rupture, and events that raise intrathoracic pressure, such as heavy lifting, can trigger rupture.<br /><br />A 59-year-old man developed acute chest pain, shortness of breath, palpitations, diaphoresis, and weakness after lifting heavy boxes. Initial evaluation showed tachycardia, elevated troponin, BNP, creatinine, and white blood cell count, but chest X-ray and early cardiac workup were unrevealing. He was admitted for further evaluation, during which he progressively worsened over several hospital days, developing severe lactic acidosis, acute kidney injury, liver failure, anemia, thrombocytopenia, and disseminated intravascular coagulation. He required intensive care, dialysis, and blood product transfusions. An initial transthoracic echocardiogram showed only aortic root dilation, but a repeat study suggested right ventricular enlargement, tricuspid regurgitation, and possible ventricular septal defect. On day 8, transesophageal echocardiography confirmed a ruptured SVA into the right atrium. He underwent emergency surgical repair with a Dacron patch and improved clinically.<br /><br />The report emphasizes that ruptured SVA can cause multiorgan failure, heart failure, arrhythmias, tamponade, and sudden death. Because diagnosis may be difficult and delayed, clinicians should consider ruptured SVA in patients with unexplained cardiogenic and systemic deterioration, especially after strenuous activity.

Asset Subtitle

Rogeliio Pinon-Gutierrez

Meta Tag

Author List Rogeliio Pinon-Gutierrez, Yee May Lwin

Category Clinical Vignettes

Concept Sinus of Valsalva Aneurysm

Concept Rupture

Concept Heart Failure

Concept Echocardiography

Concept Transesophageal Echocardiography

Distinguished Non-Finalist

Presenter Organization UC Davis Medical Center

Presenting Author Rogeliio Pinon-Gutierrez

Track Adult

Keywords

sinus of Valsalva aneurysm

rupture

aortic root

cardiac abnormality

heavy lifting

transesophageal echocardiography

right atrium

emergency surgical repair

multiorgan failure

cardiogenic deterioration

Sinus of Valsalva Aneurysm

Rupture

Heart Failure

Echocardiography

Transesophageal Echocardiography