TRANS-SYSTOLIC MURMUR DURING THE VALSALVA MANEUVER IN A PATIENT WITH APICAL ANEURYSM - A CASE-REPORT

We present a 74-year-old female in whom a systolic murmur became trans -systolic during the Valsalva maneuver. The patient had had stable eff ort angina for 20 years and coronary angiography revealed complete obs truction of the left anterior descending artery in addition to other a therosclerotic lesions. Left ventriculography showed a small apical an eurysm with a narrow orifice. Aorto-coronary bypass surgery and aneury smectomy were performed; true aneurysm was confirmed pathologically. W e conclude that apical aneurysm with a narrow orifice can produce tran s-systolic murmur.