Sinus of Valsalva Aneurysms A Unique Case of Giant Aneurysms Involving All 3 Sinuses

A 59-year–old male was admitted through the emergencyroom after falling from a ladder at a height of 12 feet. He sustained multiple fractures including a complicated proximal humeral and radial fracture. His cardiovascular physical examination was significant for a 2/4 diastolic murmur. His admission ECG (Figure 1) showed sinus rhythm with a heart rate of 59 bpm, first degree atrioventricular block and premature atrial contractions. His portable chest x-ray (Figure 2) was significant for cardiomegaly, multiple rib fractures, and multiple calcifications projecting over the cardiac silhou-ette. Because of these abnormal findings and in preparation for his orthopedic surgery, the patient underwent a transtho-racic echocardiogram, which revealed a massively enlarged aortic root with large sinuses of Valsalva aneurysms measur-ing 10 cm in diameter (Figure 3). Moderate to severe aortic regurgitation was present, and left ventricular function wa