Right sinus of Valsalva aneurysm rupture into the right ventricle in a rare cardiovascular case of syphilis

Abstract

A 55-year-old man, with prior history of syphilis, was admitted to the hospital due to chest tightness with shortness of breath. Cardiac auscultation revealed a coarse continuous murmur of grade III or higher in the aortic valve auscultation area. Laboratory tests showed elevated total antibody to syphilis, and negative serotonin for syphilis. Electrocardio-gram demonstrated complete right bundle branch conduction block and secondary ST segment alterations. Echocardiography (Figures 1 A, B) displayed four perforations of the right sinus of Valsalva (SoV) aneurysm (maximum diameter 4–5 mm) that had ruptured into the right ventricle (RV). There was a sac-like structure that had undergone calcification be-tween the right aortic sinus