Aneurysm of sinus of Valsalva
Encyclopedia
Aneurysm
of the aortic sinus
, also known as the sinus of Valsalva, is comparatively rare. When present, it is usually in either the right (65-85%) or in the noncoronary (10-30%) sinus, rarely in the left (< 5%) sinus.
or Loeys-Dietz syndrome
, but may also result from Ehlers-Danlos syndrome
, atherosclerosis
, syphilis
, cystic medial necrosis
, chest injury, or infective endocarditis
.
is performed for other reasons. A ruptured aneurysm typically leads to an aortocardiac shunt and progressively worsening heart failure.
of the aortic sinus
includes blood pressure
control through the use of drugs, such as beta blockers.
Another approach is surgical repair. The determination to perform surgery is usually based upon the diameter of the aortic root, with 5 centimeters being a rule of thumb, and the rate of increase in its size, as determined through repeated echocardiography
. (A normal size, by comparison, is 2-3 centimeters.)
Aneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...
of the aortic sinus
Aortic sinus
An aortic sinus is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve.There are generally three aortic sinuses, the left posterior, the right posterior and the anterior....
, also known as the sinus of Valsalva, is comparatively rare. When present, it is usually in either the right (65-85%) or in the noncoronary (10-30%) sinus, rarely in the left (< 5%) sinus.
Causes
This type of aneurysm is typically congenital and may be associated with heart defects. It is sometimes associated with Marfan syndromeMarfan syndrome
Marfan syndrome is a genetic disorder of the connective tissue. People with Marfan's tend to be unusually tall, with long limbs and long, thin fingers....
or Loeys-Dietz syndrome
Loeys-Dietz syndrome
Loeys-Dietz syndrome is a recently-discovered autosomal dominant genetic syndrome which has many features similar to Marfan syndrome, but which is caused by mutations in the genes encoding transforming growth factor beta receptor 1 or 2 .It was identified and characterized by American physician...
, but may also result from Ehlers-Danlos syndrome
Ehlers-Danlos syndrome
Ehlers–Danlos syndrome is a group of inherited connective tissue disorders, caused by a defect in the synthesis of collagen . The collagen in connective tissue helps tissues to resist deformation...
, atherosclerosis
Atherosclerosis
Atherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol...
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, cystic medial necrosis
Cystic medial necrosis
Familial thoracic aortic aneurysm is an autosomal dominant disorder of large arteries....
, chest injury, or infective endocarditis
Endocarditis
Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or even on intracardiac devices...
.
Presentation
If unruptured, this type aneurysm may be asymptomatic and therefore go undetected until symptoms appear or medical imagingMedical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...
is performed for other reasons. A ruptured aneurysm typically leads to an aortocardiac shunt and progressively worsening heart failure.
Treatment
Medical therapy of aneurysmAneurysm
An aneurysm or aneurism is a localized, blood-filled balloon-like bulge in the wall of a blood vessel. Aneurysms can commonly occur in arteries at the base of the brain and an aortic aneurysm occurs in the main artery carrying blood from the left ventricle of the heart...
of the aortic sinus
Aortic sinus
An aortic sinus is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve.There are generally three aortic sinuses, the left posterior, the right posterior and the anterior....
includes blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
control through the use of drugs, such as beta blockers.
Another approach is surgical repair. The determination to perform surgery is usually based upon the diameter of the aortic root, with 5 centimeters being a rule of thumb, and the rate of increase in its size, as determined through repeated echocardiography
Echocardiography
An echocardiogram, often referred to in the medical community as a cardiac ECHO or simply an ECHO, is a sonogram of the heart . Also known as a cardiac ultrasound, it uses standard ultrasound techniques to image two-dimensional slices of the heart...
. (A normal size, by comparison, is 2-3 centimeters.)
External links
See also
- Aortic aneurysmAortic aneurysmAn aortic aneurysm is a general term for any swelling of the aorta to greater than 1.5 times normal, usually representing an underlying weakness in the wall of the aorta at that location...