{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:34Z","timestamp":1740179434056,"version":"3.37.3"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\u2003<\/jats:title>\n                  <jats:p>Sinus of Valsalva aneurysm (SoVA) is a rare anomaly and can be divided into acquired and congenital forms, the latter being commonly associated with ventricular septal defects (VSDs). Rupture is a catastrophic complication with high mortality without urgent surgical intervention. We would like to highlight the use of echocardiography in an emergency setting for diagnosis and surgical intervention in a critically ill patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary\u2003<\/jats:title>\n                  <jats:p>We report a 27-year-old female with history of conservatively managed VSD known since childhood. She presented with acute decompensated cardiac failure requiring intubation and inotropic support. Bedside echocardiography performed in the emergency department suggested a ruptured SoVA at the right coronary cusp with underlying supracristal VSD. Despite the patient being critically ill with multi-organ failure, surgery was performed as it was the patient\u2019s best chance for survival. Intraoperative findings tallied with the early echocardiographic results. She recovered gradually and was eventually discharged despite a stormy post-operative period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\u2003<\/jats:title>\n                  <jats:p>This case report highlights the importance of prompt recognition of SoVA rupture by using bedside echocardiography. Surgical intervention needs to be early despite ongoing sepsis in view of acute mechanical failure. This case was unique as it illustrates a successful management of an acutely ill patient with multi-organ failure through early diagnosis, intensive perioperative stabilization, and surgical intervention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa441","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T04:26:53Z","timestamp":1606192013000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["A challenging case report of acute sinus of Valsalva aneurysm rupture in cardiogenic shock and multi-organ failure with an emphasis on rapid recognition and \u2018never giving up\u2019 in face of futility"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1381-2019","authenticated-orcid":false,"given":"Quah Wy","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Cardiology, National Heart Institute (IJN), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Jeswant Dillon","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, National Heart Institute (IJN), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0567-5536","authenticated-orcid":false,"given":"Lee","family":"Tjen Jhung","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Institute (IJN), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7219-4754","authenticated-orcid":false,"given":"Beni","family":"Isman Rusani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Institute (IJN), 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,24]]},"reference":[{"key":"2021010812222710100_ytaa441-B1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1136\/hrt.23.2.131","article-title":"Aortic sinus aneurysms","volume":"23","author":"Gibbs","year":"1961","journal-title":"Br Heart J"},{"key":"2021010812222710100_ytaa441-B2","doi-asserted-by":"crossref","DOI":"10.1016\/S0022-5223(19)37013-8","article-title":"Ruptured aneurysms of the sinus of Valsalva in Oriental patients","author":"Chu","year":"1990","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021010812222710100_ytaa441-B3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000092635","article-title":"Aneurysms of the sinuses of Valsalva","volume":"106","author":"Feldman","year":"2006","journal-title":"Cardiology"},{"key":"2021010812222710100_ytaa441-B4","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/0002-9149(75)90129-0","article-title":"Unruptured sinus of Valsalva aneurysm","volume":"35","author":"Fishbein","year":"1975","journal-title":"Am J Cardiol"},{"key":"2021010812222710100_ytaa441-B5","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/0002-8703(84)90759-2","article-title":"Natural history of subarterial infundibular ventricular septal defect","volume":"108","author":"Momma","year":"1984","journal-title":"Am Heart J"},{"key":"2021010812222710100_ytaa441-B6","first-page":"147","volume-title":"Ann Thorac Surg","author":"Ring","year":"2000"},{"key":"2021010812222710100_ytaa441-B7","first-page":"5","article-title":"Ventricular septal defects: morphology of the doubly committed juxtaarterial and muscular variants","volume":"2","author":"McCarthy","year":"2000","journal-title":"Images Paediatr Cardiol"},{"key":"2021010812222710100_ytaa441-B8","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1148\/rg.301095719","article-title":"Valsalva sinus aneurysms: findings at CT and MR imaging","volume":"30","author":"Bricker","year":"2010","journal-title":"Radiographics"},{"key":"2021010812222710100_ytaa441-B9","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1097\/00000441-200602000-00019","article-title":"Heart failure in rupture of a sinus of Valsalva aneurysm","volume":"331","author":"S\u00e1nchez","year":"2006","journal-title":"Am J Med Sci"},{"key":"2021010812222710100_ytaa441-B10","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1016\/j.athoracsur.2011.05.094","article-title":"Rupture of a left sinus of Valsalva aneurysm with coronary compression: A rare cause of ischemic chest pain","volume":"92","author":"Cuculi","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2021010812222710100_ytaa441-B11","first-page":"787","article-title":"DM. Surgical correction for sinus of Valsalva aneurysm","volume":"40","author":"Zikri","year":"1999","journal-title":"J Cardiovasc Surg"},{"key":"2021010812222710100_ytaa441-B12","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/clc.22359","article-title":"Sinus of Valsalva aneurysms: review of the literature and an update on management","volume":"38","author":"Weinreich","year":"2015","journal-title":"Clin Cardiol"},{"key":"2021010812222710100_ytaa441-B13","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S1010-7940(01)00758-8","article-title":"Approach to sinus of Valsalva aneurysms: a review of 53 cases","volume":"20","author":"Lofland","year":"2001","journal-title":"Eur J Cardio-Thoracic Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/6\/1\/35544971\/ytaa441.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/6\/1\/35544971\/ytaa441.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T23:55:24Z","timestamp":1610582124000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/6\/1\/5999164"}},"subtitle":[],"editor":[{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Chiara De","family":"Biase","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mark","family":"Abela","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Brett Sydney","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ross","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,11,24]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,11,24]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa441","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,11,24]]}}}