Which of the following statements about aneurysms of the sinus of Valsalva is/are true?

A. Aneurysms of the sinus of Valsalva are dilatations of the aortic sinuses that eventually rupture into a cardiac chamber, the pulmonary artery, or the pericardium.

B. The most common cause of an acquired sinus of Valsalva aneurysm is bacterial endocarditis

DISCUSSION: A sinus of Valsalva aneurysm is a dilatation of the aortic sinus that eventually ruptures into a cardiac chamber, the pulmonary artery, or the pericardium. The cause may be either congenital or acquired, and the most common cause of an acquired sinus of Valsalva aneurysm is bacterial endocarditis. The vast majority of sinus of Valsalva aneurysms are asymptomatic before they rupture, but if symptomatic they present as obstruction to either the left or right outflow tract, heart block, or embolization. When sinus of Valsalva aneurysms rupture, they present with symptoms of an acute left-toright shunt and these include dyspnea, palpitations, and chest pain. Finally, associated defects occur commonly with congenital sinus of Valsalva aneurysms, the most common being ventricular septal defect followed by aortic insufficiency.