Sinus of Valsalva aneurysm

Case contributed by Dr Eric F Greif


Intermittent cough and dyspnea for 3 years

Patient Data

Age: 40 years
Gender: Female

There is a 6.5 x 4.5 cm aneurysm arising from the right coronary cusp of the sinus of Valsalva, immediately below the origin of the right coronary artery. This causes moderate mass effect/compression upon right atrium and ventricle. 

Mild pectus excavatum is present.


Status post repair of right sinus of Valsalva aneurysm. Mild cardiomegaly with small pericardial effusion. Small left pleural effusion with associated mild left lower lobe passive atelectasis.

Case Discussion

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. In this case, surgical repair was performed.

Sinus of Valsalva aneurysms can be acquired or congenital (Marfan syndrome or Ehlers–Danlos syndrome1. In this case, the cause of her sinus of Valsalva aneurysm is not known.

ECG-gated, contrast-enhanced multisection CT is used to provide better spatial resolution of cardiac structures and detailed anatomy (as used in this case).

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