Right Coronary Sinus of Valsalva Aneurysm Dissecting into the Interventricular Septum: A Rare Presentation

Abstract Sinus of Valsalva (SOV) aneurysm is a benign congenital cardiac anomaly that can remain asymptomatic until the rupture occurs, leading to dramatic hemodynamic effects. Ruptured SOV (RSOV) can produce interventricular dissection, valvular dysfunction, and heart failure if left untreated. We describe the case of a 28-year-old male with a diagnosis of RSOV from the right coronary sinus, dissecting into the interventricular septum and causing biventricular dysfunction. He presented with a worsening dry cough and effort palpitations, which then evolved into acute heart failure symptoms. Imaging confirmed the rupture, which necessitated surgical repair through patch closure and aortic valve replacement. We portray the imperative need for early diagnosis and early surgical intervention of RSOV to prevent life-threatening complications and improve patient outcomes.