Ruptured Right Sinus of Valsalva Aneurysm to the Right Atrium Mimicking Acute Myocardial Infarction

We present a rare case involving a ruptured sinus of Valsalva aneurysm (SVA) and acute myocardial infarction in a 39-year-old male patient. Coronary angiography showed normal findings; however, the patient showed remarkably elevated levels of cardiac enzymes and decreased left ventricular function with apical akinesia on transthoracic echocardiography. Transesophageal echocardiography revealed shunt flow from the SVA to the right atrium without significant aortic regurgitation. Preoperative cardiac arrest was managed by cardiopulmonary resuscitation, and surgical repair was performed by closing the entrance of the aneurysm. However, the compromised hemodynamic status was not reversed by surgery.