Ruptured aneurysm of the sinus of Valsalva into the right atrium. An uncommon congenital heart defect

Rupture of an aneurysm of the sinus of Valsalva is an uncommon heart defect. A continuous murmur may be the first clinical sign of this rupture. Additional imaging techniques, and in the first place echocardiography, can be used to confirm the diagnosis. We present a case where, at the age 53 years, the diagnosis was made of a ruptured sinus of Valsalva into the right atrium, with a typical windsock image on echocardiogram. Although several cases of a ruptured sinus of Valsalva are reported in the literature, it is still an underdiagnosed condition because it is frequently missed during physical examination.