Rupture of the sinus of Valsalva mimicking tricuspid valve vegetation in a healthy, young male adult.

A 24-year-old male patient presented with symptoms of acute progressive dyspnea and chest pain. Transthoracic echocardiography demonstrated a mobile mass-like lesion attached to the tricuspid valve, as well as a holodiastolic flow reversal in the descending and abdominal aorta, as increased retrograde flow. We also evaluated the vegetation-like lesion by transesophageal echocardiography. As a result, we were able to diagnose the rupture of the sinus of Valsalva with shunt flow between the aorta and the right heart that had manifested as sudden chest pain and acute dyspnea. The patient underwent surgical repair for this ruptured lesion. After surgery, there was no evidence of residual shunt flow. The objective of this report is to describe a rare presentation of a ruptured sinus of Valsalva and to discuss the importance of adequate diagnosis using advanced imaging modalities. <Learning objective: If the rupture of sinus of Valsalva remains untreated, prognosis could be poor. Prompt diagnosis and timely surgical correction are important, as is further evaluation by transesophageal echocardiography imaging, which could be mandatory for adequate diagnosis.>.