Diagnostic Considerations

Clinicians should keep in mind sinus of Valsalva aneurysm (SVA) rupture in young patients (especially those with minimal cardiac risk factors) who have signs and symptoms of myocardial ischemia, heart failure, or cardiac conduction defects. Definitive treatment is available, yet the prognosis is poor if rapid diagnosis cannot be made.

Other conditions to consider include chest pain and arrhythmia/syncope. In addition, SVA may mimic myocardial infarction or present with cerebrovascular embolism.^{[15, 16]}

Differential Diagnoses

Workup

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Media Gallery

Sinus of Valsalva Aneurysm. An axial slice from an electrocardiography (ECG)-gated computed tomographic angiogram (CTA) demonstrates an aneurysm of the right sinus of Valsalva (arrow). There is a filling defect within the aneurysm consistent with a thrombus.
Sinus of Valsalva Aneurysm. A parasagittal slice from an electrocardiography (ECG)-gated computed tomographic angiogram (CTA) demonstrates a right sinus of Valsalva aneurysm (arrow). There is a filling defect within the aneurysm consistent with a thrombus.
Sinus of Valsalva Aneurysm. A three-dimensional reconstruction of a computed tomographic (CT) aortogram is shown, demonstrating a right sinus of Valsalva aneurysm (arrow).
Sinus of Valsalva Aneurysm. A mid-esophageal short-axis echocardiogram demonstrates a ruptured right sinus of Valsalva aneurysm. Color doppler demonstrates flow into the right ventricle.
Sinus of Valsalva Aneurysm. A mid-esophageal long-axis echocardiogram demonstrates a ruptured right sinus of Valsalva aneurysm. Color doppler demonstrates flow into the right ventricle.

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Author

Arnold S Baas, MD, FACC, FACP Professor of Medicine, Division of Cardiology, Fellowship Director for Advanced Heart Failure and Transplant Cardiology, Ahmanson UCLA Cardiomyopathy Center, Mechanical Circulatory Support, and Heart Transplant Program, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Ronald Reagan UCLA Medical Center

Arnold S Baas, MD, FACC, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Society of Echocardiography, International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Small, MD Adult Congenital Cardiology Fellow, Ahmanson/UCLA Adult Congenital Heart Disease Center, University of California, Los Angeles, David Geffen School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Steven J Compton, MD, FACC, FACP, FHRS Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals

Steven J Compton, MD, FACC, FACP, FHRS is a member of the following medical societies: American College of Physicians, American Heart Association, American Medical Association, Heart Rhythm Society, Alaska State Medical Association, American College of Cardiology

Disclosure: Nothing to disclose.

Chief Editor

Yasmine S Ali, MD, MSCI, FACC, FACP Assistant Clinical Professor of Medicine, Vanderbilt University School of Medicine; President, LastSky Writing, LLC

Yasmine S Ali, MD, MSCI, FACC, FACP is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, American Medical Writers Association, National Lipid Association, Tennessee Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: LastSky Writing;Philips Healthcare;M Health;Athena Health;PeerView Institute;Verywell Health; HealthCentral;MedEdicus;Pharmaceutical Training Institute;Elsevier;MedStudy;North American Thrombosis Forum;WellnessVerge;Prose Media; AKH, Inc.<br/>Serve(d) as a speaker or a member of a speakers bureau for: North American Thrombosis Forum.

Additional Contributors

Anuradha Tunuguntla, MD, FACC Interventional Cardiologist, Director of Cardiac Catheterization Lab, Veterans Affairs Medical Center of Wilkes Barre, PA

Anuradha Tunuguntla, MD, FACC is a member of the following medical societies: American College of Cardiology, Society for Cardiovascular Angiography and Interventions

Disclosure: Nothing to disclose.

Acknowledgements

William J Stewart, MD Professor, Department of Cardiovascular Disease, The Cleveland Clinic Lerner College of Medicine

William J Stewart, MD, is a member of the following medical societies: American College of Cardiology and American Society of Echocardiography

Disclosure: Nothing to disclose.

Wai Hong Wilson Tang, MD Associate Professor of Medicine, Section of Heart Failure and Cardiac Transplantation Medicine, Cleveland Clinic Foundation

Wai Hong Wilson Tang, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, American Society for Clinical Investigation, Heart Failure Society of America, and International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.