"Aneurysmal sinus of Valsalva" and possible heart failure?

Hello,

I'm a 41 yr old female, 5'7" 135 lbs, non-smoker, have suffered from ankle swelling and fatigue for 15 years, infrequent shortness of breath for 10 years, doctors have ruled out kidney problems as a a cause of the edema, and was given inhalers for the "asthma" although no pulmonary function test was ever done. 5 years ago, I was told I have a heart murmur, but no follow-up testing was done.

In the last 2 years, the edema, shortness of breath and fatigue has worsened, especially after exercise. After walking a couple of miles I often just collapse on the sofa and fall asleep. This never used to be the case, but I guess it came on so gradually I haven't really noticed until now. Now, after eating, I'm often exhausted. I often have "air hunger", even at night when trying to sleep; have always thought it was asthma and taken my inhaler. Occasionally I startle awake at night coughing, feeling like I'm choking/not breathing. Symptoms are worse in hot and humid weather and when I don't get enough sleep.

A year ago, doctor ordered an Echocardiogram wih Dopplar, which she did not follow up on so I assumed it was normal. However I just obtained a copy of the results and noticed they included: "Aneurysmal Sinus of Valsalva". (It also included "mild insufficiency" of the Tricuspid valve.) Everything else appears normal (to me, anyway). Given my symptoms, should I be concerned about either, especially the "Aneurysmal Sinus of Valsalva"?

Many thanks,

[Dr J Singh]

Hi,
This is one of the rare congenital diseases. In this the sinus of aortic valve can get widened/dilated and its called the aneurysm and usually they are asymptomatic and no intervention is required. However, the medical treatment consists of ensuring a normal blood pressure by giving beta blockers and surgical intervention is only entertained if the diameter of the aortic root is > 5cm. I sincerely hope that helps. Take care.