Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly which has potential for spontaneous rupture into other cardiac chambers or the pericardial space (depending on its location). A ruptured SVA has a very poor prognosis with high morbidity and mortality. The development of a shunt between the sinus of Valsalva and right-sided cardiac chambers results in a continuous murmur on examination. Our case report is a case of SVA rupture into the right atrium. In this case report, we describe a 23-year-old patient with an acute onset of chest pain, shortness of breath, palpitations and dizziness starting 2 days prior to presentation to the emergency department. The patient was initially treated for presumed pulmonary embolism overnight while awaiting CTPA the next morning. However, further examination by the inpatient medical team demonstrated a continuous machinery cardiac murmur. Subsequent echocardiography demonstrated an acutely ruptured SVA with shunting to the right atrium. Emergency surgical repair resulted in an excellent outcome for the patient. A thorough clinical history and physical examination is the cornerstone of all medical encounters. An SVA could be asymptomatic until acute rupture. Echocardiography is the preferred initial diagnostic tool. Additional imaging techniques can be used to confirm the diagnosis. In cases of rupture, prognosis is poor and surgical repair is always required.

中文翻译：

---

Valsalva动脉瘤的窦口急性破裂至右心房：病例报告和叙述回顾。

窦静脉窦动脉瘤（SVA）是一种罕见的心脏异常，有可能自发破裂进入其他心脏腔或心包间隙（取决于其位置）。SVA破裂的预后很差，发病率和死亡率很高。瓦尔萨尔瓦窦与右侧心脏腔室之间的分流发展导致检查时出现连续性杂音。我们的病例报告是一例SVA破裂至右心房。在此病例报告中，我们描述了一名23岁的患者，在就诊前两天开始出现急性胸痛，呼吸急促，心pal和头晕。该患者最初在第二天早上等待CTPA的同时接受了过夜的肺栓塞治疗。然而，住院医疗团队的进一步检查显示出连续性机械性心脏杂音。随后的超声心动图检查显示，SVA急性破裂并分流至右心房。紧急外科手术修复为患者带来了极好的结果。全面的临床病史和体格检查是所有医疗活动的基石。SVA在急性破裂之前可能没有症状。超声心动图是首选的初始诊断工具。可以使用其他成像技术来确认诊断。如果发生破裂，预后很差，总是需要手术修复。全面的临床病史和体格检查是所有医疗活动的基石。SVA在急性破裂之前可能没有症状。超声心动图是首选的初始诊断工具。可以使用其他成像技术来确认诊断。如果发生破裂，预后很差，总是需要手术修复。全面的临床病史和体格检查是所有医疗活动的基石。SVA在急性破裂之前可能没有症状。超声心动图是首选的初始诊断工具。可以使用其他成像技术来确认诊断。如果发生破裂，预后很差，总是需要手术修复。