[Aneurysm of the sinus of Valsalva and late rupture of the interventricular septum due to infective endocarditis. Is the two-dimensional echocardiography of endocarditic extension into the interventricular septum possible?].

In a 54 year old woman affected by infective endocarditis, with bicuspid aortic valve and aneurysm of sinus of Valsalva protruding into the right atrium, two-dimensional echocardiography helped to identify altered myocardial echo patterns of the interventricular septum at basal level. Because of the proximity with valvular lesions due to endocarditis, we could interpret these appearances as produced by invasion of the infective process into the septum. The autopsy report of septum rupture in the same area further supports our interpretation of the echocardiographic finding.