RESUMEN
ABSTRACT: Aneurysm of sinus Valsalva is a defined as dilatation of the sinuses located between the aortic valve annulus and the sinotubular junction and mostly found in the right coronary sinus. It can be either congenital or acquired. This condition is usually asymptomatic unless it can cause intracardiac rupture or aortic valve insufficiency. Extracardiac rupture and associated fatal cases of cardiac tamponade are extremely rare. Our case is one of the rare cases in the literature that was diagnosed during autopsy. Our case is 65-year-old male patient with a history of hypertension suddenly fell ill after swimming in the sea. On gross examination of heart, there was an aneurysmatic enlargement of the right sinus Valsalva measuring 4.5 × 4 cm with a hemorrhagic appearance on the outer surface and a 0.3 cm rupture area. Histopathological examination revealed hemorrhage in and around the aneurysm wall.
Asunto(s)
Aneurisma de la Aorta , Rotura de la Aorta , Muerte Súbita , Seno Aórtico , Humanos , Masculino , Anciano , Seno Aórtico/patología , Muerte Súbita/etiología , Rotura de la Aorta/patología , Aneurisma de la Aorta/patología , Hemorragia/patología , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/patologíaRESUMEN
BACKGROUND AND AIMS: Atherosclerosis is the primary underlying cause of myocardial infarction and stroke, which are the major causes of death globally. Heparanase (Hpse) is a pro-inflammatory extracellular matrix degrading enzyme that has been implicated in atherogenesis. However, to date the precise roles of Hpse in atherosclerosis and its mechanisms of action are not well defined. This study aims to provide new insights into the contribution of Hpse in different stages of atherosclerosis in vivo. METHODS: We generated Hpse gene-deficient mice on the atherosclerosis-prone apolipoprotein E gene knockout (ApoE-/-) background to investigate the impact of Hpse gene deficiency on the initiation and progression of atherosclerosis after 6 and 14 weeks high-fat diet feeding, respectively. Atherosclerotic lesion development, blood serum profiles, lesion composition and aortic immune cell populations were evaluated. RESULTS: Hpse-deficient mice exhibited significantly reduced atherosclerotic lesion burden in the aortic sinus and aorta at both time-points, independent of changes in plasma cholesterol levels. A significant reduction in the necrotic core size and an increase in smooth muscle cell content were also observed in advanced atherosclerotic plaques of Hpse-deficient mice. Additionally, Hpse deficiency reduced circulating and aortic levels of VCAM-1 at the initiation and progression stages of disease and circulating MCP-1 levels in the initiation but not progression stage. Moreover, the aortic levels of total leukocytes and dendritic cells in Hpse-deficient ApoE-/- mice were significantly decreased compared to control ApoE-/-mice at both disease stages. CONCLUSIONS: This study identifies Hpse as a key pro-inflammatory enzyme driving the initiation and progression of atherosclerosis and highlighting the potential of Hpse inhibitors as novel anti-inflammatory treatments for cardiovascular disease.
Asunto(s)
Aorta , Aterosclerosis , Glucuronidasa , Ratones Noqueados para ApoE , Placa Aterosclerótica , Animales , Masculino , Ratones , Aorta/patología , Aorta/metabolismo , Aorta/enzimología , Enfermedades de la Aorta/patología , Enfermedades de la Aorta/genética , Enfermedades de la Aorta/enzimología , Enfermedades de la Aorta/metabolismo , Apolipoproteínas E/genética , Apolipoproteínas E/deficiencia , Aterosclerosis/genética , Aterosclerosis/patología , Aterosclerosis/enzimología , Aterosclerosis/metabolismo , Dieta Alta en Grasa , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Glucuronidasa/deficiencia , Glucuronidasa/genética , Glucuronidasa/metabolismo , Ratones Endogámicos C57BL , Ratones Noqueados , Necrosis , Seno Aórtico/patología , Molécula 1 de Adhesión Celular Vascular/metabolismoRESUMEN
BACKGROUND: Sinus of Valsalva aneurysm (SVA) is an extremely rare condition, and its rupture causes acute symptoms such as chest pain and dyspnea. Ruptured SVA is frequently associated with other congenital defects. CASE PRESENTATION: A 37-year-old male presented with SVA originating from the left coronary sinus that ruptured into the interventricular septum. SVA was diagnosed by echocardiography, cardiac computed tomography and magnetic resonance imaging, and confirmed during the operation. CONCLUSIONS: SVA is a rare cardiac abnormality which can lead to severe clinical symptoms upon rupture. Immediate surgery is necessary to repair the ruptured SVA.
Asunto(s)
Aneurisma de la Aorta , Enfermedades de la Aorta , Disección Aórtica , Rotura de la Aorta , Seno Coronario , Seno Aórtico , Tabique Interventricular , Masculino , Humanos , Adulto , Seno Aórtico/diagnóstico por imagen , Seno Aórtico/cirugía , Seno Aórtico/patología , Tabique Interventricular/diagnóstico por imagen , Tabique Interventricular/cirugía , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/cirugía , Enfermedades de la Aorta/complicaciones , Rotura de la Aorta/diagnóstico , Rotura de la Aorta/diagnóstico por imagenRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Lesiones Precancerosas/diagnóstico , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Rotura de la Aorta/diagnóstico por imagen , Seno Aórtico/diagnóstico por imagen , Anomalías de los Vasos Coronarios/complicaciones , Ecocardiografía/métodos , Rotura de la Aorta/patología , Seno Aórtico/patología , Hipertensión/diagnóstico , Vasos Coronarios/diagnóstico por imagenRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Trombosis/diagnóstico por imagen , Seno Aórtico/diagnóstico por imagen , Seno Aórtico/patología , Aneurisma/diagnóstico por imagen , Cateterismo Cardíaco/métodos , Fibrinolíticos/uso terapéutico , Dolor en el Pecho/diagnóstico por imagen , Dolor en el Pecho/etiología , Angiografía/métodos , Ecocardiografía/métodos , Warfarina/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéuticoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aneurisma Roto/diagnóstico por imagen , Infarto del Miocardio/complicaciones , Choque Cardiogénico/complicaciones , Choque Cardiogénico/diagnóstico por imagen , Seno Aórtico/diagnóstico por imagen , Seno Aórtico/patología , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Hipertensión/complicaciones , Dolor en el Pecho/diagnóstico por imagen , Dolor en el Pecho/etiologíaAsunto(s)
Humanos , Femenino , Seno Aórtico/anomalías , Seno Aórtico/diagnóstico por imagen , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Seno Aórtico , Seno Aórtico/patología , Tomografía Computarizada por Rayos X/métodos , Angiografía Coronaria/métodos , Anomalías de los Vasos Coronarios/patología , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico por imagenRESUMEN
Trazemos neste artigo a descrição de uma peça anatômica especificamente preparada para demonstrar uma rara anomalia da origem da artéria coronária esquerda do seio de Valsalva direito, com incidência de 0,15% em pacientes submetidos a cinecoronariografia. Trata-se de um subgrupo de anomalias das artérias coronárias que tem o maior potencial para repercussões clínicas, em especial a morte súbita em jovens. Discutimos, à luz dos conhecimentos atuais, os mecanismos fisiopatológicos, o diagnóstico e as opções de tratamento das variações anatômicas da origem anômala da artéria coronária do seio contralateral.
This article reports an anatomic specimen specifically prepared to demonstrate a rare anomaly of the origin of the left coronary artery from the right sinus of Valsalva, with an incidence of 0.15% in patients undergoing coronary angiography. This is a subgroup of coronary artery anomalies with the greatest potential for clinical repercussions, especially sudden death in young patients. Based on current knowledge, pathophysiologic mechanisms, diagnosis and treatment options of anatomical variations of the anomalous origin of a coronary artery from the contralateral sinus are discussed.
Asunto(s)
Humanos , Adulto Joven , Anomalías de los Vasos Coronarios/genética , Anomalías de los Vasos Coronarios/patología , Vasos Coronarios/fisiopatología , Vasos Coronarios/patología , Malformaciones Vasculares/genética , Malformaciones Vasculares/patología , Muerte Súbita Cardíaca/patología , Seno Aórtico/patologíaRESUMEN
O Aneurisma do Seio de Valsalva (ASV) é um distúrbio cardíaco raro. É mais frequentemente um defeito congênito, mas pode ser adquirido. A doença de Takayasu é uma causa extremamente rara desse distúrbio. A maioria dos casos de ASV não-roto é assintomática. A compressão da artéria coronária esquerda é uma manifestação não usual da doença, que pode causar angina, infarto do miocárdio ou morte. Esse relato de caso descreve um paciente negro de 19 anos, do sexo masculino, apresentando um ASV direito não-roto causado por doença de Takayasu, manifestado através de síndrome coronariana aguda, tratada cirurgicamente com sucesso.
Sinus of Valsalva aneurysm is a rare cardiac disorder. It is more frequently a congenital, but it may also be an acquired condition. Takayasu's disease is an extremely rare cause of this disorder. Most cases of unruptured sinus of Valsalva aneurysm are asymptomatic. Compression of the left coronary artery is an unusual manifestation of the disease that can cause angina, myocardial infarction or death. This report describes a 19-year-old black male with an unruptured right sinus of Valsalva aneurysm caused by Takayasu's disease and manifested by an acute coronary syndrome, successfully treated by surgery.
Aneurisma del Seno de Valsalva (ASV) es un disturbio cardíaco raro. Con mayor frecuencia se trata de un defecto congénito, pero puede ser adquirido. La enfermedad de Takayasu es una causa extremadamente rara de este disturbio. La mayoría de los casos de ASV no roto es asintomática. La compresión de la arteria coronaria izquierda es una manifestación no usual de la enfermedad, que puede causar angina, infarto de miocardio o muerte. Este informe de caso describe un paciente negro, de 19 años, del sexo masculino, presentando un ASV derecho no roto causado por enfermedad de Takayasu, manifestado a través de síndrome coronario agudo, tratado quirúrgicamente con éxito.
Asunto(s)
Humanos , Masculino , Adulto Joven , Síndrome Coronario Agudo/complicaciones , Aneurisma de la Aorta/etiología , Seno Aórtico , Arteritis de Takayasu/complicaciones , Síndrome Coronario Agudo/patología , Aneurisma de la Aorta/patología , Seno Aórtico/patología , Adulto JovenRESUMEN
Se describe un paciente con ruptura de aneurisma del seno Valsalva derecho, diagnosticado por ecocardiografía transtoracica bidimensional y doppler, con historia previa de insuficiencia cardiaca derecha y soplo continuo en precordio.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Aneurisma Cardíaco/diagnóstico , Aneurisma , Ecocardiografía , Seno Aórtico/patologíaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Anciano de 80 o más Años , Aneurisma/complicaciones , Aneurisma/diagnóstico , Seno Aórtico/patología , Seno Aórtico , Fístula/cirugía , Aneurisma , Disnea/complicaciones , Edema/complicaciones , Edema/diagnóstico , Seno Aórtico/fisiopatología , Fístula Vascular/terapiaAsunto(s)
Adulto , Humanos , Masculino , Aneurisma de la Aorta/etiología , Coartación Aórtica/etiología , Coartación Aórtica/patología , Válvula Aórtica/anomalías , Hipertensión/complicaciones , Dolor Abdominal/etiología , Aneurisma de la Aorta/patología , Cardiomegalia/etiología , Cardiomegalia/patología , Resultado Fatal , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/patología , Choque/etiología , Seno Aórtico/patologíaRESUMEN
No disponible
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Aneurisma Roto/complicaciones , Aneurisma Roto/diagnóstico , Aneurisma Roto/cirugía , Aneurisma Cardíaco/complicaciones , Aneurisma Cardíaco/cirugía , Ibuprofeno/uso terapéutico , Angiografía/instrumentación , Aneurisma Roto , Aneurisma Cardíaco/fisiopatología , Aneurisma Cardíaco , Seno Aórtico/patología , Seno Aórtico , Radiografía Torácica/métodos , Amoxicilina/uso terapéutico , Ventilación Pulmonar/fisiología , EcocardiografíaRESUMEN
A case of saccular aneurysms of the right and posterior aortic sinuses of Valsalva in a 60-year old Negro man is presented. The aneurysms produced progressive congestive cardiac failure and heart block. It is postulated that the aneurysms were congenital in origin. A simple method of classifying the aortic sinuses is given and theories of the pathogenesis of aortic sinus aneurysms are discussed. The literature is reviewed. Clinical diagnosis of aneurysms of the aortic sinuses of Valsalva by retrograde aortography and the feasibility of surgical repair are mentioned (AU)
Asunto(s)
Humanos , Persona de Mediana Edad , Masculino , Aneurisma de la Aorta , Seno Aórtico , Aortografía , Seno Aórtico/anomalías , Seno Aórtico/patologíaRESUMEN
We report a case of a 21 year old female who presented with congestive cardiac failure. In initial investigations an aneurysm of sinus of Valsalva was found ruptured to the pulmonary artery. It was surgically repaired uneventfully. The patient was discharged home after 10 days. During the follow-up appointments she was found to have reappearing symptoms of congestive cardiac failure. This lead to her readmission and a repeated cardiac catheterization found her to have an aneurysm of sinus of Valsalva ruptured to the right ventricule, which in a second operation was succesfully repaired. We review the bibliography over the last 20 years finding tne unusual presentation of the rupture to the pulmonary artery. We point out the importance of a sharp clinical examination and the preference of cardiac catheterization to make the diagnosis