A 78-year-old man with unruptured aneurysm of Valsalva found accidentally by syncope during straining

Abstract

A 78-year-old man who suffered from syncope and light-headedness during straining. The patient visited to our department for evaluation of his symptom. Cardiac auscultation revealed a grade II/IV systolic murmur along the left parasternal border. Electrocardiography showed T wave inversion at the right precordial leads. Echocardiography demonstrated an unruptured aneurysm originating at the sinus of Valsalva protruding into the right ventricular outflow tract. Cardiac cathtererization demonstrated a pressure gradient of 34 mmHg between the right ventricular cavity and pulmonary artery with a large aneurysm originating from the right coronary cusp. Because of his low activity of daily living owing to old cerebral infarction, we managed the patient conservatively.