From clues to clarity: multimodality imaging uncovers ruptured sinus of Valsalva aneurysm masquerading as tricuspid valve endocarditis.

Ruptured sinus of Valsalva aneurysm (RSOVA) is a rare but life-threatening condition that may be misdiagnosed due to nonspecific symptoms. We report the case of a 24-year-old postpartum female who presented with acute right heart failure and was initially misdiagnosed with tricuspid valve infective endocarditis. Detailed evaluation revealed RSOVA originating from the right coronary sinus with left-to-right shunting into the right ventricle. This case highlights the importance of clinical suspicion and multimodal imaging for accurate diagnosis in postpartum females presenting with dyspnea, chest pain, and a continuous murmur. Early diagnosis and timely intervention are crucial to improving outcomes.