Let’s be real: most of us don’t look our best after a night of heavy drinking.

So when one man woke up with a swollen face and puffy eyelids, he figured he was just paying the price of partying. 

Instead of being a result of last night’s alcohol consumption, the cause of his suffering was a rare and dangerous heart condition. One mistake, made with good intentions, almost took his life.

Three months, no answers

When the swelling didn’t let up, the 33-year-old Chinese man sought medical help — but doctors came up empty.

Initially, tests showed no issues with his heart, but doctors observed abnormally high levels of protein in his urine. This prompted them to consider it as a possible explanation for the swelling in his face. They prescribed medication and sent him home.

But his condition only got worse. 

Gradually, the swelling extended from his face to the rest of his body. His chest started feeling constricted, his abdomen became bloated, yet there was still no clear diagnosis in sight.

After bouncing from appointment to appointment, he was finally admitted to the emergency room at Qilu Hospital in Qingdao — three months after the symptoms first appeared.

That’s when doctors finally uncovered the real cause: a ruptured sinus of Valsalva aneurysm (RSOVA) — a rare and potentially deadly heart condition. 

In the Journal of Medical Case Reports, doctors wrote that they believe the rupture was likely triggered by “strenuous exercise” after drinking alcohol, which caused the face of the “previously healthy” man to swell. 

Something to think about before hitting the gym hungover.

A heart on the brink

Sinus of Valsalva aneurysms are rare, affecting just 0.09% of the population. Most people don’t know they have one until it ruptures, often triggered by activities like vigorous exercise or heavy lifting.

When that rupture happens, symptoms can vary wildly: from chest pain and shortness of breath to fainting, fatigue — or, in this man’s case, a slow, creeping full-body swell.

Left untreated, RSOVA often leads to heart failure and death within a year. But with early diagnosis and surgical repair, the long-term survival rate is typically strong.

Doctors who eventually diagnosed the 33-year-old patient said that earlier health care providers missed several “key indicators” — including a rumbling sound in the heartbeat that can be a sign of a rupture.

That misdiagnosis, they wrote, “delayed appropriate intervention” and allowed the patient’s condition to worsen, posing a “serious risk.”

By the time he arrived at the emergency department at Qilu Hospital, his symptoms had escalated to full-blown acute heart failure.

Further testing identified an aneurysm that was affecting one of the heart’s four chambers — and doctors rushed him into emergency surgery.

Luckily, the rupture was successfully repaired, and 18 months later, the patient is recovering well with no complications.

In their report, doctors said the case highlights why medical teams should be quicker to consider RSOVA in younger patients presenting with signs of heart failure — a condition that’s typically affects older adults. 

“It is therefore important to develop a strategy for the early recognition of aortic sinus aneurysm rupture,” they wrote.