Large sinus of Valsalva aneurysm presenting as acute coronary syndrome

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Medical Imaging

Background:

• Sinus of Valsalva aneurysms are rare congenital or acquired defects.
• Typically asymptomatic, they can lead to severe complications if large or ruptured.
• Left coronary sinus origin is less common but can cause significant coronary artery compression.

Observation:

• A 56-year-old male presented with worsening chest pain.
• Coronary imaging identified a 4.6-cm sinus of Valsalva aneurysm originating from the left coronary sinus.
• The aneurysm significantly compressed the left main coronary artery, including the left anterior descending and proximal circumflex arteries.

Findings:

• The patient underwent successful surgical repair involving aortic root and ascending aortic replacement.
• Post-operative outcomes were favorable, with resolution of symptoms.

Implications:

• Large sinus of Valsalva aneurysms pose a significant risk of sudden cardiac events.
• Early diagnosis and surgical intervention are crucial for managing these potentially life-threatening conditions.
• This case highlights the importance of advanced imaging in diagnosing coronary artery compression by aortic abnormalities.