A 33-year-old man in Qingdao, China, woke after a night of heavy drinking with facial swelling and puffy eyes, mistaking these symptoms for a hangover. In reality, he was experiencing a ruptured sinus of Valsalva aneurysm (RSOVA), a rare and potentially deadly heart abnormality.
Over three months, his condition worsened. Facial swelling spread to his entire body, his chest tightened, and abdominal swelling appeared. Initial tests showed high protein in the urine, which misled clinicians away from a cardiac diagnosis. The breakthrough came after his admission to the emergency department at Qilu Hospital, where doctors linked the rupture to strenuous exercise following alcohol use. The finding was reported in the Journal of Medical Case Reports.
RSOVAs affect about 0.09% of people worldwide. Symptoms range from mild chest discomfort and shortness of breath to severe fatigue and full-body swelling. If left undetected, RSOVA can lead to heart failure and often fatal outcomes within a year. Early surgical repair, however, markedly improves survival chances.
According to a cardiologist at Qilu Hospital, earlier misdiagnoses delayed life-saving intervention and allowed heart function to deteriorate, with critical signs such as a faint heartbeat murmur going unnoticed. Emergency surgery ultimately relieved symptoms and stabilized the patient.
This case highlights the need to consider RSOVA in younger patients who present cardiopulmonary symptoms—not just in older individuals. Early recognition and timely management are essential to prevent irreversible damage.
In Thailand, where lifestyle factors and healthcare access vary, increasing RSOVA awareness can support proactive care. Thai clinicians can draw lessons from this case to strengthen protocols for detecting RSOVA in patients with nontraditional risk factors.
The patient’s recovery demonstrates the effectiveness of timely surgical repair. For Thai readers, the takeaway is to seek medical attention for unusual post-exercise symptoms or swelling, especially when alcohol is involved, rather than dismissing them as mere fatigue.
Looking ahead, expanding access to advanced diagnostic tools for aneurysms could help Thai health systems identify RSOVA earlier. A proactive approach aligns with international best practices and could advance cardiac care in Thailand.