Sinus of Valsalva aneurysm: An uncommon presentation
In November 2011, a 46-year-old man was referred to our heart clinic in Isfahan (Iran) for more evaluations. He had been suffering from nonspecific symptoms such as exercise intolerance and weakness for a few months. The performed physical and psychiatric evaluations had not shown a specific pathology. His physical activities were not reduced significantly and he was not under medical therapy.\nOn admission, the patient had a regular pulse with an apical pulse of 80 beats per minute (bpm). The heart sounds were normal. His electrocardiogram was also normal with an approximate rate of 80-90 bpm and nonspecific ST-T changes. TTE was performed for further evaluation. Ejection fraction was 60%. There was no valve stenosis or regurgitation. Echocardiography did not reveal atrial or ventricular enlargement. A large tumor-like mass was observed in the right ventricle (). More meticulous assessment showed the mass to be related to sinus Valsalva. This diagnosis was confirmed by TEE (). Computed tomography angiography (CTA) was used for detailed evaluation of the mass ().\nOpen heart surgery with intraoperative TEE was performed and an SVA with lots of clots was removed. The postoperative course was uneventful and the patient was discharged without any symptoms or residual mass ().