CTICasesRuptured Sinus of Valsalva Aneurysm
Imaging findings
CT and cardiac MRI demonstrate a large, congenital aneurysm of the right coronary sinus of Valsalva that has ruptured into the right ventricle, creating a left-to-right shunt. Associated findings include a supercristal ventricular septal defect (VSD) located immediately below the right coronary cusp. Flow-sensitive MRI sequences show the shunt jet.
Key takeaways
Rupture of a sinus of Valsalva aneurysm is a rare cardiovascular event, most commonly involving the right coronary sinus rupturing into the right ventricle or atrium. It is strongly associated with a supracristal VSD. The high-velocity shunt jet across the VSD pulls the adjacent sinus wall into the defect (windsock effect), leading to progressive aneurysm formation and eventual rupture, presenting with acute chest pain and a continuous murmur.
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