Not so benign- A rare cause of right ventricular outflow tract ventricular tachycardia in patient with congenital heart disease

Right ventricular outflow tract ventricular tachycardia (RVOT VT) is a well-recognised subtype of idiopathic ventricular tachyarrhythmia and often described in young healthy individuals. This arrhythmia typically occurs in patients with a structurally normal heart, and in this context is generally considered benign. In this case we present a rare association between RVOT VT and a ruptured sinus of Valsalva aneurysm in a patient known to have a restrictive ventricular septal defect. Prompt surgical intervention was necessary to prevent potentially life threatening consequences.The diagnostic and surgical evaluation learnt from this case would be useful to remind clinicians to explore rarer causes of RVOT VT especially when patients have underlying congenital heart disease. This case also highlights the importance of utilizing multi-modality imaging for the anatomical assessment of this pathology, which aids definitive management.