Unique Pattern of Aortic Regurgitation Caused by Rupture Into the Left Ventricular Interleaflet Triangle of a Sinus Valsalva Aneurysm Involving the Left Coronary Cusp
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A 43-year-old man with a primary complaint of prolonged paroxysmal coughing was admitted to our hospital for evaluation of a to-and-fro heart murmur. When he initially visited our hospital, his heart failure symptom was classified as New York Heart Association functional classification III. His upper limb blood pressure was 129/52 mm Hg and, pulse rate was 95 beats/min. He had a normal respiratory rate with an O2 saturation of 98% on room air. Moreover, his lower limb blood pressure was 190/48 mm Hg. Hence, transthoracic echocardiography was performed for suspected severe aortic regurgitation based on physical findings. However, transthoracic echocardiography showed a flattened, saccular aneurysm originating in the right sinus of Valsalva, which enlarged at the septum of the left ventricle and appeared to rupture into the left ventricular outflow tract (Figure, A and B). After this, cardiac computed …