Aneurysm of the sinus of Valsalva rupturing into the pulmonary infundibulum. Echographic study

Rupture of a Sinus of Valsalva aneurysm into the pulmonary infundibulum with ventricular septal defect was diagnosed by M mode echocardiography The differential diagnosis was prolapse of an aortic valve cusp associated with ventricular septal defect. The relevant features were the presence of an echo anterior to the anterior aortic wall. This echo was related to the aortic valve as a small posterior movement was recorded at aortic valve closure. Systolic fluttering of the pulmonary valve suggested a degree of subvalvular obstruction. Diastolic fluttering was related to the aortic regurgitation immediately below the pulmonary valve. This case confirms the hypothesis that the anterior echo produced by the aortic valve is in fact the left anterior coronary cusp.