Acute aortic regurgitation caused by spontaneous aortic valve rupture

We report a rare case that manifested as severe aortic regurgitation (AR) resulting from spontaneous aortic valve (AV) rupture caused by valvular myxomatous transformation in a middle-aged woman. Before operation, 1 ruptured hole on the left coronary cusp (LLC) was clearly visualized with transesophageal echocardiography (TEE). There were no clinical findings of vegetations or sinus Valsalva aneurysms. The patient was treated successfully with mechanical AV replacement. Prompt imaging evaluation is mandatory in this rare critical situation for correct diagnosis and appropriate management.