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A 48-year-old male with a history of progressive atrioventricular conduction disturbance and a peculiar diastolic regurgitant murmur was reported. The echocardiographic examination and cineangiography disclosed an aneurysm of the right coronary sinus of Valsalva ruptured into the interventricular septum, which bulged into the left ventricular outflow tract in diastole and moved toward the septum in systole. The intracardiac phonocardiogram revealed that an unperforated sac in the interventricular septum, protruded into the left ventricular outflow tract, caused an unusual regurgitant murmur. The patient underwent successful surgical repair of the perforated orifice.
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