JACC. Case reports · 2026
Reversible Complete Atrioventricular Block Due to Rupture of the Left Coronary Aortic Sinus.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Kawase Ken, Nakajima Kenzaburo, Miyazaki Yuichiro, Mori Shumpei, Masuda Taizo, Horinouchi Hiroki, Kitai Takeshi, Fukuda Tetsuya, Kusano Kengo
Аннотация
BACKGROUND: Rupture of the left coronary aortic sinus complicated by conduction disturbances has not been reported.
CASE SUMMARY: An 85-year-old woman presented with chest and back pain and a complete atrioventricular block, which led to low-output syndrome. Imaging revealed a rupture of the left coronary aortic sinus with a pseudoaneurysm and a hematoma extending toward the central fibrous body. Conservative management was selected, and atrioventricular conduction gradually improved as the hematoma regressed.
DISCUSSION: The hematoma compressed the atrioventricular node region, causing a reversible atrioventricular block. Infective endocarditis, antineutrophil cytoplasmic antibody-associated vasculitis, atherosclerosis, and localized dissection involving the sinuses of Valsalva have been discussed as potential mechanisms underlying this rare condition.
TAKE-HOME MESSAGE: Spontaneous rupture of the sinuses of Valsalva and the resultant hematoma extending around the central fibrous body can cause a reversible complete atrioventricular block by mechanical compression of the atrioventricular node region.
CASE SUMMARY: An 85-year-old woman presented with chest and back pain and a complete atrioventricular block, which led to low-output syndrome. Imaging revealed a rupture of the left coronary aortic sinus with a pseudoaneurysm and a hematoma extending toward the central fibrous body. Conservative management was selected, and atrioventricular conduction gradually improved as the hematoma regressed.
DISCUSSION: The hematoma compressed the atrioventricular node region, causing a reversible atrioventricular block. Infective endocarditis, antineutrophil cytoplasmic antibody-associated vasculitis, atherosclerosis, and localized dissection involving the sinuses of Valsalva have been discussed as potential mechanisms underlying this rare condition.
TAKE-HOME MESSAGE: Spontaneous rupture of the sinuses of Valsalva and the resultant hematoma extending around the central fibrous body can cause a reversible complete atrioventricular block by mechanical compression of the atrioventricular node region.