The sinus of Valsalva aneurysm is a relatively rare condition that may be congenital or acquired. We present a case of a young man who was admitted to the emergency department with acute dyspnoea whilst playing football. After investigation, the diagnosis of a ruptured right sinus of Valsalva aneurysm into the right atrium was made. The patient also had a bicuspid aortic valve. Percutaneous approach to close the fistula was unsuccessful and the patient underwent surgical closure of the fistula with replacement of his bicuspid aortic valve.