PMC3795016_01
CXR showing bilateral lung congestion.
amjcaserep-14-398-g001.jpg
PMC3795016_01_amjcaserep-14-398-g001.jpg
f1-amjcaserep-14-398
Chest X-ray showed congestion of both lung fields (Figure 1), with normal heart size.
ECG showing LV strain, ST depression in lateral leads.
amjcaserep-14-398-g002.jpg
PMC3795016_01_amjcaserep-14-398-g002.jpg
f2-amjcaserep-14-398
TEE showing the non-coronary sinus with aneurysmal dilatation and rupture (fistulization) to the right atrium (arrow): RA - Right Atrium, AA - Aortic Valve area, NCC - Non-Coronary Cusp of the aortic valve.
amjcaserep-14-398-g003.jpg
PMC3795016_01_amjcaserep-14-398-g003.jpg
f3-amjcaserep-14-398
TEE showed acute AR grade III-IV, possible a ruptured non-coronary cusp with fistula formation to the right atrium (Figure 3) and possible type A aortic dissection starting at the non-coronary sinus.