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Rupture of sinus of Valsalva aneurysm (RSOV)

Sinus of Valsalva aneurysm is usually due to a defect in the aortic media. A ventricular septal defect or aortic regurgitation may be found as associated abnormalities. Nearly 70% of aneurysms originate from the right coronary sinus. The aneurysm may compress an adjacent chamber, coronary artery, or conduction system. These can cause myocardial ischemia or conduction disturbances. About one third of aneurysms rupture and produce acute symptoms in a quarter of patients. Important symptoms following rupture are dyspnea, chest pain and fatigue. If it ruptures into the right sided chambers, it produces a left to right shunt. The severity of shunt and associated lesions determine the severity of symptoms.