Sinus of Valsalva aneurysm (SVA) is one of the rare cardiac anomalies described in the literatures and ruptured sinus of valsalva (RSOV) is a form of left-to- right shunt .The presentation may range from dyspnea to cardiogenic shock and death. Here we present a case of very rare presentation of a RSOV to right atrium and right ventricle.