Ruptured non-coronary sinus of Valsalva aneurysm into the right atrium in 44-year-old patient

We hereby present a case report of ruptured sinus of Valsalva aneurysm into the right atrium in 44-year-old patient with 8-month progressive exertional dyspnoea, occasional palpitations and oedema of lower extremities. A massive left-to-right shunt between the outflow tract of the left ventricle and right atrium was discovered from the echocardiogram examination. The patient was indicated for surgery, during which it was discovered a defect in the area of the non-coronary sinus extending into the right atrium, calcifications in the annulus of the congenitally bicuspid aortic valve, without signs of endocarditis present, abundant tissue was excised from the right atrium which had originally been an aneurysm of the non-coronary sinus of the aortic root. Sinus of Valsalva aneurysm is a very rare pathology which is generally asymptomatic. In this case it manifested through a rupture into the right atrium and symptomatology of right-sided heart failure. Surgery was the only possible treatment.