CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1670164
This article is part of the Research TopicCardiovascular Imaging Case Reports 2025: Emphasizing Uncommon Clinical ScenariosView all 8 articles
When the Culprit Lies Outside the Coronary Artery: Dual Case Report of Coronary Sinus of Valsalva Dissection Presenting as STEMI
Provisionally accepted
- Changde Hospital, Xiangya School of Medicine, Central South University, The First People's Hospital of Changde City, Changde, China
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Located sinus of Valsalva (SOV) dissection is a rare but critical condition that presents as inferior ST-segment elevation myocardial infarction (STEMI). We present two cases in which computed tomography angiography (CTA) was essential in identifying SOV dissection. In the first case, CTA confirmed a localized dissection of the right SOV. Surgical revascularization was delayed owing to initial diagnostic challenges and the family's hesitation, which ultimately led to a fatal outcome. In the second, intravascular ultrasound (IVUS) confirmed extrinsic compression of the right coronary artery (RCA), and following emergency stent implantation, coronary blood flow was restored, conservative treatment achieved a favorable clinical outcome. These cases highlight the pivotal role of early CTA when angiographic findings are incongruent with the clinical presentation, the utility of IVUS in determining the etiology of coronary artery occlusion, and the critical importance of timely revascularization.
Keywords: sinus of Valsalva dissection, computed tomography angiography, ST-elevation myocardial infarction, coronary artery bypass grafting, Intravascular ultrasound
Received: 21 Jul 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Chen, Yu and Ling. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kun Chen, Changde Hospital, Xiangya School of Medicine, Central South University, The First People's Hospital of Changde City, Changde, China
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