title: Sinus of Valsalva aneurysm--an unusual cause of syncope.
abstract: Sinus of Valsalva aneurysms (SOVA) are rare anomalies which often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient right ventricular outflow tract (RVOT) obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope. SOVA are rare anomalies that often only become apparent at the time of rupture. Syncope associated with unruptured aneurysms is a recognized symptom but in most previously reported cases the mechanism has been either a brady- or tachyarrhythmia. We report a case of a large SOVA affecting the right coronary cusp, which presented with syncope secondary to hypotension thought to be resulting from reduced left atrial filling as a consequence of transient RVOT obstruction. The case demonstrates how echocardiographic and angiographic images correlate and also an unusual mechanism of syncope.
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Eastern Road, Brighton, United Kingdom. manavsohal@hotmail.com
authors.forename: Manav
authors.initials: M
authors.lastname: Sohal
authors.forename: Ronak
authors.initials: R
authors.lastname: Rajani
authors.forename: Adam
authors.initials: A
authors.lastname: de Belder
mesh_terms: D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging*; D013575:Syncope / Q000000981:diagnostic imaging* / Q000209:etiology*