Heart 1998;80:202-203 ( August )
Short cases in cardiology
Interventricular septal expansion of a sinus of Valsalva aneurysm: a rare cause of complete heart block
Department
of Cardiology, East Yorkshire Cardiothoracic Centre, Cottingham, East
Yorkshire HU16 5JQ, UK
Correspondence to: Dr Walters.
Accepted for publication 14 January 1998
| The first 150 words of the full text of this article appear below. |
We present the case of a 64 year old man, previously of good health, who presented in November 1995 with a short history of presyncope and one witnessed episode of syncope. On admission he was clinically in complete heart block with a ventricular rate of 40 beats/min but had a well maintained blood pressure at 150/80 mm Hg. Auscultation revealed a soft systolic murmur in the aortic area. The remainder of the examination was unremarkable. Resting ECG confirmed complete AV block with a slow regular broad complex ventricular escape rhythm. A Paragon III (Pacesetter, Coventry, UK) dual chamber pacemaker was subsequently implanted with complete resolution of cardiac symptoms.
He remained well for three months when he presented with sudden
onset dyspnoea in January 1996. Further examination at this time
revealed signs of pulmonary congestion and a cardiac murmur throughout
systole and diastole that had changed in character from the previous
evaluation. There were no peripheral
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