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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 4, July/August 2016
AFRICA
e13
the right atrium and CS aneurysm. Therefore, it was reasonable
to presume that the main cause of the two venous aneurysms
was longstanding right heart diastolic failure. Based on the high
pressure of the two aneurysms and complications of severe right
heart failure, cardiac transplantation may be the only treatment
option for this patient.
TDI was helpful in the diagnosis. TDI is a contemporary
echocardiographic tool that allows the measurement of intrinsic
myocardial velocity. The e
′
velocity reflects early diastolic
ventricular relaxation in the longitudinal plane, and the s
′
velocity
reflects systolic function in the longitudinal plane. Values of
e
′
(septal)
<
8 cm/s are suggestive of impaired myocardial
relaxation.
13
In this patient, two TDI echocardiography
examinations both showed a reduced e
′
velocity and a normal s
′
velocity. These results strongly suggested a long history of right
heart diastolic failure.
Conclusion
To our knowledge, this is the first reported case of simultaneous
presentation of giant aneurysms of the coronary sinus and
superior vena cava. Acquired venous aneurysms may result
from longstanding right heart failure. The combination of
echocardiography, contrast-enhanced CT and cardiac
catheterisation facilitated the diagnosis of combined giant venous
aneurysms and provided strong evidence for this aetiology.
This study was supported by grants from the National Natural Science
Foundation, People’s Republic of China (No. 81371571).
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