CASE OF A FEMALE PATIENT WITH ANKYLOSING SPONDYLITIS AND MULTIPLE ANEURYSMS

Blagovest Stoimenov, L. Gaydarski, Svetla Dineva, R. Pancheva
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Abstract

Aneurysms of the Valsalva sinuses are rare among cardiovascular disorders, with an incidence rate of 0.15%. Most cases are accidentally diagnosed or constated postmortem. Usually, this type of pathology is asymptomatic and might go undetected for a long time before the aneurism erupts. Patients with larger coronary aneurysms often complain of from chest pain, shortness of breath, and arrhythmia. Another extremely rare cardiovascular pathology is the aneurysm of the subclavian artery, which has a reported rate of 0.13%. Smaller subclavian aneurysms have no clinical manifestation, whereas larger ones cause murmur, pulsation phenomenons, neuropathic pain and ischemia of the upper limb due to compression of the brachial plexus and major vessels. Herein, we report a rare case of a very large aneurisms involving all three coronary sinuses and the whole aortic root in combination with a bilateral giant subclavian aneurism. These findings were made during a routine cardiological examination and further hospitalizations of a 54-year-old woman with chest pain and high blood pressure complaints with known ankylosing spondylitis. Despite their rarity, aneurysms of the sinuses of Valsalva and subclavian arteries are of utmost clinical significance due to the life-threatening complications which might arise from their rupture. Furthermore, such aneurysms pose significant technical difficulties during angiographic procedures. Therefore, detailed knowledge of such pathologies is essential for correctly diagnosing and treating such patients.
一名患有强直性脊柱炎和多发性动脉瘤的女性患者的病例
瓦尔萨尔瓦窦动脉瘤在心血管疾病中较为罕见,发病率为 0.15%。大多数病例是意外诊断或死后发现的。通常情况下,这类病变没有症状,可能在动脉瘤爆发前很长时间都未被发现。患有较大冠状动脉瘤的患者通常会主诉胸痛、气短和心律失常。另一种极为罕见的心血管病变是锁骨下动脉瘤,据报道发病率为 0.13%。较小的锁骨下动脉瘤没有临床表现,而较大的锁骨下动脉瘤会因压迫臂丛神经和大血管而引起杂音、搏动现象、神经性疼痛和上肢缺血。在此,我们报告了一例罕见的巨大动脉瘤病例,该动脉瘤累及所有三个冠状动脉窦和整个主动脉根部,并伴有双侧巨大锁骨下动脉瘤。这些发现是在对一名患有强直性脊柱炎、胸痛和高血压的 54 岁女性进行常规心脏检查和进一步住院治疗时发现的。尽管瓦尔萨尔瓦窦动脉瘤和锁骨下动脉瘤非常罕见,但由于其破裂可能引发危及生命的并发症,因此具有极其重要的临床意义。此外,此类动脉瘤还会给血管造影术带来很大的技术难度。因此,要正确诊断和治疗此类患者,就必须详细了解此类病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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