title: Right heart obstruction from a balloon-like sinus of Valsalva aneurysm in a patient with Down syndrome.
abstract: A 40-year-old man with Down syndrome presented with right heart failure. He was markedly obese and had severe developmental delay. There was marked edema and an early diastolic sound. Transthoracic echocardiography suggested a right heart mass. Transesophageal echocardiography revealed an unruptured balloon-like sinus of Valsalva aneurysm within the right atrium that obstructed the tricuspid orifice. The patient died in hospital of mixed obstructive and/or septic shock.
authors: St. Michael's Hospital, University of Toronto, Toronto, Canada.
authors: S Douglas
authors: SD
authors: Lee
authors: Majo
authors: M
authors: Joseph
authors: A Stephane
authors: AS
authors: Lambert
authors: C David
authors: CD
authors: Mazer
authors: Stuart J
authors: SJ
authors: Hutchison
mesh_terms: D000328:Adult; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004314:Down Syndrome; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva; D018497:Ventricular Dysfunction, Right / Q000209:etiology*; D014694:Ventricular Outflow Obstruction / Q000209:etiology*