Rare presentation of multiple sinuses of Valsalva Aneurysms with rupture into the right atrium: An autopsy case

In forensic practice, multiple sinuses of Valsalva Aneurysm resulting in death have rarely been reported. Here, we present the case of a 55-year-old man who was admitted to hospital with vomiting and recurrent abdominal pain. Ultrasonography showed that the aorta non-coronary sinus had an expansion to the right atrium with a range of about 19mm × 16mm and a rupture at the top of the aorta with a width of about 5mm. The movement of the left ventricular wall was uncoordinated. During the autopsy, forensic scientists found that the deceased also had a right coronary sinus of the aorta. To be exact, the wall of the aorta at the bottom was enlarged in a tuberous manner and bulged into the right ventricular outflow tract, partially obstructing the right ventricular outflow tract. The cause of death was considered to be acute right heart failure caused by the sinus of Valsalva Aneurysm complicated with the non-coronary sinus aneurysm puncturing into the right atrium, followed by multiple organ failure. In cases of unexplained death, the sinus of the Valsalva Aneurysm should be carefully examined because the aneurysm may be asymptomatic and the possibility of rupture cannot be ignored. This case demonstrated an effective post-mortem diagnostic entity and highlights the significance of post-mortem examination in dealing with unexplained deaths.