Rupture of Sinus of Valsalva aneurysm (SVA) may be either congenital or acquired. This report describes a case of intracardiac shunting of a ruptured SVA of atherosclerotic origin to the right atrium, presenting with acute myocardial infarction. The sinus of Valsalva aneurysm and the intracardiac shunt track into the right atrium was not defined by the two-dimensional echocardiography could be seen by 64-slice multi detector computed tomography (MDCT).