Abstract
Echocardiography is widely used in the evaluation of patients with chest pain and can provide important information regarding left ventricular function, valvular competency, and structural defects. The authors report a patient in whom transesophageal echocardiography confirmed the presence of a sinus of Valsalva aneurysm (SVA), an uncommon congenital defect of the proximal aorta that may be associated with high morbidity and mortality. Aneurysm of the sinus of Valsalva results from the separation of the aortic media from the aortic annulus. It is often the result of a congenital cardiac defect but can also be acquired in patients with Marfan's syndrome, after cardiac surgery or trauma, and as a result of infection. This is a rare case of an SVA causing coronary artery compression, resulting in chest pain, coronary ischemia, and ventricular tachycardia.