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Silent rupture of sinus of Valsalva aneurysm: a refutation of the Okham's razor principle

Published online by Cambridge University Press:  24 May 2011

Joseph Dayan ,
Suvro Sett  and
Usha Krishnan
Joseph Dayan
Affiliation:
Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, United States of America
Suvro Sett
Affiliation:
Department of Pediatric Cardiothoracic Surgery, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, United States of America
Usha Krishnan*
Affiliation:
Department of Pediatric Cardiology, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, United States of America Department of Pediatric Cardiology, Children's Hospital of NY Presbyterian, Columbia University Medical Center, New York, United States of America
*
Correspondence to: Dr U. Krishnan, MD, Pediatric Cardiology, 3959 Broadway, 2 North, Suite 255, Columbia University Medical Center, New York, New York 10032, United States of America. Tel: 212 305 4436; Fax: 212 342 1443; E-mail: [email protected]
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Abstract

Aneurysm of the sinus of Valsalva is an uncommon congenital lesion rarely reported in children. Unruptured aneurysms commonly go undiagnosed until a rupture has occurred. Usually, ruptured sinus of Valsalva presents with cardiac failure. There may be a history of trauma or infective endocarditis preceding the rupture. Asymptomatic paediatric presentation of ruptured sinus of Valsalva is rare. We discuss the cases of two children who presented with a murmur and were diagnosed with ruptured sinus of Valsalva. This unusual presentation in children highlights the importance of careful routine physical examinations and the evaluation of new murmurs. The Okham's razor principle states that “when you hear hoofbeats – think horses not zebras”. Sometimes, it is important to think beyond the usual in medicine, to avoid missing lesions that, if left untreated, could lead to adverse outcomes.

Keywords

Aortic sinuscongenitalventricular septal defect
Type
Brief Reports
Information
Cardiology in the Young , Volume 21 , Issue 6 , 28 October 2011 , pp. 713 - 715
Copyright
Copyright © Cambridge University Press 2011

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References

1.Goldberg, N, Krasnow, N. Sinus of Valsalva aneurysms. Clin Cardiol 1990; 13: 831–836.Google Scholar
2.Azakie, A, David, TE, Peniston, CM, Rao, VR, Williams, WG. Ruptured sinus of Valsalva aneurysm: early recurrence and fate of the aortic valve. Ann Thorac Surg 2000; 70: 1466–1471.CrossRefGoogle ScholarPubMed
3.Ott, DA. Aneurysm of the sinus of Valsalva. Pediatr Card Surg Ann 2006; 9: 165–176.Google Scholar
4.Vural, KM, Sener, E, Tasdemir, O, Bayazit, K. Approach to sinus of Valsalva aneurysms: a review of 53 cases. Eur J Cardiothorac Surg 2001; 20: 71–76.CrossRefGoogle ScholarPubMed
5.Au, W, Chiu, S, Mok, C, Lee, W, Cheung, D, He, G. Repair of ruptured sinus of Valsalva aneurysm: determinants of long-term survival. Ann Thorac Surg 1998; 66: 1604–1610.CrossRefGoogle ScholarPubMed
6.Kakos, GS, Kilman, JW, Williams, TE, Hosier, DM. Diagnosis and management of sinus of Valsalva aneurysm in children. Ann Thorac Surg 1974; 17: 474–478.CrossRefGoogle ScholarPubMed
7.Burakovsky, VI, Podsolkov, VP, Sabirow, BN, Nasedkina, MA, Alekian, BG, Dvinyaninova, NB. Ruptured congenital aneurysm of the sinus of Valsalva. J Thorac Cardiovasc Surg 1988; 95: 836–841.CrossRefGoogle ScholarPubMed
8.Nowicki, ER, Aberdeen, E, Friedman, S, Rashkind, WJ. Congenital left aortic sinus-left ventricle fistula and review of aortocardiac fistulas. Ann Thorac Surg 1977; 23: 378–388.Google Scholar