An uncommon cause of a continuous murmur

Area of Science:

• Cardiovascular Medicine
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Aneurysms of the sinus of Valsalva (ASV) are uncommon cardiac anomalies, typically congenital.
• Most ASVs originate from the right coronary sinus; other causes include trauma, endocarditis, and syphilis.
• Unruptured ASVs are often asymptomatic, while rupture can present with a continuous murmur.

Observation:

• This report details a rare case of an aneurysm originating from the noncoronary sinus of Valsalva.
• The aneurysm was observed to have ruptured into the right atrium.
• Unruptured aneurysms are often asymptomatic, but rupture typically presents with a continuous murmur.

Findings:

• Rupture into the right atrium is a less common presentation of sinus of Valsalva aneurysms.
• Continuous murmurs along the left sternal border are characteristic findings post-rupture.
• The specific case highlights a noncoronary sinus origin, a rare anatomical location.

Implications:

• Early diagnosis and surgical intervention are crucial for favorable outcomes.
• Understanding the diverse origins and rupture sites of ASV is important for clinical management.
• This case contributes to the literature on rare presentations of sinus of Valsalva aneurysms.