Rupture of sinus of valsalva aneurysm: earliest presentation in association with ventricular septal defect and aortic regurgitation

Abstract

Rupture of sinus of Valsalva aneurysm (SVA) is a rare cardiac lesion, generally occurring in second to fourth decades of life. Ruptured SVAs are frequently associated with other congenital defects, particularly with ventricular septal defect, aortic valve regurgitation, and bicuspid aortic valve. The malformation arises due to lack of continuity between the aortic media and the annulus fibrosus of the aortic valve. The structure becomes aneurysmal and may rupture to form a fistula. They are rare in paediatric patients. We describe here, a four year old female child being managed previously as a case of ventricular septal defect and aortic regurgitation deteriorates progressively. Transthoracic echocardiography revealed rupture of sinus of valsalva aneurysm into the right ventricle along with ventricular septal defect with aortic regurgitation. We report here earliest presentation of ruptured sinus of valsalva aneurysm which had been misdiagnosed as ventricular septal defect.