Sinus of Valsalva aneurysm complications include rupture and mass effect on adjacent cardiac structures causing ventricular outflow tract obstruction, compression of a coronary artery leading to myocardial ischemia, and arrhythmias 1.
This patient's complaint of shortness of breath was likely secondary to the aneurysm causing mass effect and relative right ventricular outflow tract obstruction. The patient in this case went on to have surgical repair as seen above.
Sinus of Valsalva aneurysms can be acquired or congenital (Marfan syndrome or Ehlers–Danlos syndrome) 1. In this case we are unsure how the patient obtained a sinus of Valsalva aneurysm.
ECG gated, contrast-enhanced multisection CT is used to provide better spatial resolution of cardiac structures and detailed anatomy (as used in this case).