Rupture of the aortic sinus aneurysm, also known as rupture of the Valsalva sinus aneurysm, occurs due to the lack of normal elastic and muscular tissues in the aortic sinus wall. Under the impact of high-pressure blood flow, a sac-like tumor gradually forms, protrudes outward, and may eventually rupture. This condition is a relatively rare congenital heart disease. The disease has a higher incidence in adults, with sudden onset and rapid progression. Clinical manifestations primarily include sudden severe chest pain, palpitations, shortness of breath, and a tendency to induce heart failure. Surgical treatment is highly effective, with low mortality rates, and normal cardiac function can be fully restored postoperatively. However, severe heart failure cases have higher surgical mortality rates and slower postoperative recovery. Therefore, early surgery is recommended.

bubble_chart Clinical Manifestations

1. Sudden onset of chest pain, palpitations, and shortness of breath after most activities; severe cases may lead to heart failure. 2. A continuous machinery-like murmur can be heard at the left sternal border in the 3rd-4th intercostal space, radiating to the precordial area, accompanied by a thrill. There may also be water-hammer pulse and pistol-shot sounds over large arteries.

bubble_chart Diagnosis

1. Sudden chest pain, palpitations, and shortness of breath; 2. A continuous machinery-like murmur is heard at the left sternal border in the 3rd-4th intercostal space, accompanied by a tremor, with water-hammer pulse and pistol-shot sounds over large vessels. 3. Electrocardiogram: Left ventricular high voltage or biventricular hypertrophy. 4. X-ray examination: Enlarged cardiac shadow and increased lung markings. 5. Color Doppler echocardiography: Detection of the aortic sinus aneurysm and the location and size of its rupture. 6. Cardiac catheterization: Left-to-right shunt at the right atrial or right ventricular level. 7. Cardiac angiography: Reveals the site where the sinus aneurysm ruptures into the heart.

1. Surgical Indications: Surgery should be performed promptly upon diagnosis. 2. Surgical Contraindications: Small, unruptured, and asymptomatic aortic sinus aneurysms. 3. Surgical Treatment: Aortic sinus aneurysm repair under extracorporeal circulation.

This disease is a congenital malformation and cannot be cured by medical treatment. For unruptured aortic sinus aneurysms, close monitoring is essential. Once the aneurysm ruptures, symptoms become obvious, and the condition progresses rapidly, sometimes severely. Immediate surgical repair of the ruptured aneurysm is required after diagnosis. The mortality rate for aneurysm repair is very low, and the surgical outcomes are definitive. Postoperative cardiac function can improve or return to normal completely, though the efficacy is poorer in cases with severe cardiac insufficiency. Patients should rest and undergo follow-up examinations in the short term after surgery.

bubble_chart Cure Criteria

1. Cured: After surgical treatment, the heart murmur disappears, there are no obvious symptoms, and no significant complications. 2. Improved: Basically meets the above criteria, but symptoms have improved. Patients with poor recovery of cardiac function still require continued medical treatment. 3. Not Cured: Symptoms show no improvement after medical treatment.