Echocardiographic observation before and after rupture of an aneurysm of the sinus of valsalva associated with ventricular septal defect

A 22-year-old man was admitted for the evaluation of ventricular septal defect (VSD) associated with aneurysm of the sinus of Valsalva. The diagnosis of an unruptured aneurysm of the right sinus of Valsalva associated with high VSD was confirmed by echocardiography and cineangiography. The patient felt palpitation while awaiting surgery on the outpatient bases 3 weeks after he had been discharged. Echocardiography and ECG monitoring confirmed rupture of the aneurysm of the sinus of Valsalva associated with ventricular arrhythmia. This case demonstrates the usefulness of transthoracic as well as transesophageal echocardiography associated with Doppler color flow mapping in detecting aneurysm of the sinus of Valsalva, and, further, that incidental aneurysm of the sinus of Valsalva is a candidate for emergent open-heart surgery.