SOB and increasing infiltrates in a 49 year old

July 29, 2008

This 49 year old male had been healthy but presented with increasing SOB. Below are the radiographs in the first 6 days in the hospital

A CT was done.  Two representative images are below
The CT shows a sinus of valsalva aneurysm that is nearly completing obliterating the LA cavity approximately 4 cm, causing a pulmonary venous obstruction. See the enclosed echo report from SMH and a brief reference.  echo-report-s-of-v  s-of-v-cardiolgy
While I could find reports of S of V aneurysm causing Ra-RV inflow obstruction, I could not find a similar case of a LA obstruction as in this presentation.  There are 3 sinuses of Valsalva, so it likely is that one is more susceptible to aneurysm formation but that is my own speculation.