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A case of acute myocardial infarction possibly caused by Valsalva aneurysm of the right and noncoronary sinuses Takeshi Ishide 1 , Masato Nakamura 1 , Hiroyuki Takada 1 , Yhoichirho Furukawa 1 , Akira Nakayama 1 , Toshihiro Saitho 1 , Michikazu Ogawa 1 , Yoshiaki Inagaki 1 , Shoichi Furuta 2 , Takashi Ino 2 , Hidco Adachi 2 1The Third Department of Internal Medicine, Chiba University School of Medicine 2Department of Surgry, Mitsui Memorial Hospital pp.1381-1387
Published Date 1985/11/15
DOI https://doi.org/10.11477/mf.1404204778
  • Abstract
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This is a 62 year old, thin and tall, male patient who developed acute myocardial infarction possiblycaused by Valsalva aneurysm associated with Mar-fan syndrome. The patient first noticed exertional dyspnea in 1971 and cardiac hypertrophy associated with atrial fibrillation was subsequently diagnosed in 1979. One year later, Valsava aneurysm with aortic regurgitation was confirmed by x-ray CT, RI angiography and echocardiography.

On August 5th, 1982, while working, the patient developed severe precordial pain and cold sweating lasted for several hours. Two weeks later, the patient was admitted to the cardiology department, Chiba University Hospital and inferior myocardial infarction was confirmed by the findings of serial cardiac enzymatic, electrocardiographic and RI scintigraphic studies. After completion of the car-diac rehabilitation program, the surgical operation was performed at Mitsui Memorial Hospital. Atthe surgery, it was confirmed that an aneurysm with 10cm diameter originating from the right coronary and noncoronary sinuses compressed the right coronary artery and aortic valve dilatation caused aortic regurgitation. Aortoplasty and artifi-cial aortic valve replacement were successfully per-formed and the postoperative course was unevent-ful.

Since the serological test for syphilis was negative and the histological study did not disclosed inflam-matory changes, but severe fragmentation, atrophy and disappearance of elastic fibers in the resected aneurysmal wall, the diagnosis was thought to be compatible with an incomplete type of Marfan syndrome. The patient has been entirely free from any cardiac symptom after the surgery.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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