An Unusual Cause of Recurrent Syncope: Sinus of Valsalva Aneurysm

Sinus of Valsalva aneurysm (SOVA) is a rare anomaly, commonly caused by the congenital absence of elastic and muscular tissue of the sinus aortic wall. This condition often becomes apparent at the time of rupture. The most recently reported case of syncope in unruptured SOVA was due to Tachy-Brady arrhythmia involving the conduction system. This type of aneurysm also presents with signs and symptoms of ventricular outflow tract obstruction, mimicking ventricular tumor. We report a case of recurrent syncope during exertion resulting from SOVA involving the right coronary cusp, without additional symptoms such as angina, malignant arrhythmias, or infection. The mechanisms remain unknown but may be either the consequence of transient left ventricular outflow tract obstruction or cardiac arrhythmia causing syncope during exertion. This case report presents an unusual cause of syncope and demonstrates a correlation between echocardiography and CT angiography images.