Aneurysm of sinus of Valsalva

Synonyms

2

Overview

Aneurysm of the aortic sinus is comparatively rare, occurring in about one person in every thousand. When present, it is usually in either the right (65-85%) or in the noncoronary (10-30%) sinus, rarely in the left (< 5%) sinus.

Symptoms

  • Asymptomatic until rupture
  • Aortic regurgitation
  • Distorted aortic valve
  • Palpitations
  • Fainting

Causes

This type of aneurysm is typically congenital and may be associated with heart defects. It is sometimes associated with Marfan syndrome or Loeys-Dietz syndrome, but may also result from Ehlers-Danlos syndrome, atherosclerosis, syphilis, cystic medial necrosis, chest injury, or infective endocarditis.

Primary causes: 

  • Congenital

Secondary causes:

  • Atherosclerosis
  • Syphilis
  • Cystic medial necrosis or Marfan syndrome
  • Blunt or penetrating chest injury
  • Infective endocarditis

Associated congenital defects

  • Ventricular septal defect
  • Aortic insufficiency
  • Coarctation

Treatment

Medical therapy of aneurysm 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.)

Resources

  • NIH