RUPTURED SINUS OF VALSALVA ANEURYSM SIMULATING ENDOCARDITIS

A previously healthy, 31-year-old man was evaluated in the emergency d epartment after being violently assaulted. A harsh, continuous murmur was noted on physical examination. Transthoracic and transesophageal e chocardiograms were interpreted as showing a ruptured sinus of Valsalv a aneurysm with a shunt into the right atrium and a tricuspid valve ve getation. The patient was treated with antibiotics for presumed endoca rditis. Subsequent echocardiographic and surgical evaluation showed no evidence of past or present endocarditis. Rather, the sinus of Valsal va aneurysm and rupture gave the appearance of a valvular mass. This r eport shows some of the potential pitfalls in the delineation of abnor malities related to sinus of Valsalva aneurysms and rupture.