Acute rupture of a congenital sinus of Valsalva aneurysm after severe exercise

Ruptured aneurysms of the sinus of Valsalva may cause manifestations of prompt onset. A 22-year-old man with no previous cardiac complaints presented with dyspnea, palpitation, fatigue, and shortness of breath, all of which occurred after a football match. Transthoracic echocardiography showed an aneurysmal dilatation of the right sinus of Valsalva to the direction of the right ventricle. Color Doppler imaging showed a marked left-to-right turbulent flow from the aortic root to the right ventricle. Continuous Doppler imaging also revealed a continuous left-to-right systolodiastolic shunting. The patient was submitted to cardiovascular surgery for surgical repair.