Subject(s)
Coronary Disease/diagnosis , Echocardiography , Heart Block/diagnosis , Hemodynamics , Diagnostic Errors , Humans , RiskABSTRACT
M-mode echocardiography has proved in these last years to be a reliable method for the recognition and evaluation of several cardiac diseases, both congenital and acquired. The following is a case we have examined in which M-mode echocardiography has allowed us to diagnose a Valsalva sinus aneurysm combined with a bicuspid aortic valve causing a valvular steno-insufficiency. We discuss the genesis of an echogram situated in the left ventricular outflow tract. A very similar image had been ascribed in the past to the rupture of an aneurysm into the interventricular septum, which caused a filling of the septum itself in diastole and therefore the echogram described above. On the basis of two-dimensional echocardiography, angiography and the autoptic report we could exclude this hypothesis in our case. We suggest that the image might be due to a prolapse of the valvular leaflet in the left ventricular outflow tract and/or to the prolapse of the aneurysm itself in the tract between the valvular leaflet and the interventricular septum.