Sinuses of Valsalva (SOV) are three small outpouchings at the root of the aorta. Each takes its name from its relation to the origin of a coronary artery. Therefore we have a Left SOV, a Right SOV and a Non-coronary SOV. Rupture of a sinus of valsalva is a rare condition. Its manifestations are protean with an asymptomatic murmur in one end to as acute, cardiogenic shock leading to death at the other extreme. This great variation is influenced by the SOV involved and the cavity it ruptures

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... Diagnosing the condition is a challenge not only because of the rarity of the condition but also because the wide variety of symptoms given. How to proceed with a surgical correction is also not clearly outlined because of the same reason. Here we present how we arrived at a diagnosis by correlating the symptoms and the multitude of investigations done. We also describe our surgical correction resulting in a satisfactory outcome. Abstract Here we present a case involving a middle aged male patient suffering from ruptured left Sinus Of Valsalva (SOV) and attendant complications. The rarity of the condition presents a clinical dilemma in the diagnosis and treatment of the same. Occurrences are so rare that not much comprehensive guideline is available for the medical team to proceed with treatment. We describe how we arrived at the diagnosis by correlating the various investigations done and also the surgical correction done resulting in a satisfactory outcome.