Can a hidden heart condition mimic angina? This case report presents a rare instance of giant unruptured sinus of Valsalva aneurysms (SVA) causing angina pectoris in a 64-year-old female. While SVAs are uncommon cardiac anomalies, this report highlights an unusual presentation where the aneurysm, despite being unruptured, led to significant cardiovascular symptoms. The case underscores the importance of considering rare causes in patients presenting with exertional dyspnea and angina. The patient's condition was characterized by exertional dyspnea and angina pectoris over three months. Diagnostic imaging confirmed unruptured left-coronary and non-coronary SVAs. Notably, the left anterior descending artery and left circumflex artery were stretched and compressed by the SVA, resulting in myocardial ischemia. The patient underwent aortic root replacement (Bentall procedure), leading to symptom relief. This case emphasizes the diagnostic challenges posed by giant unruptured SVAs and the critical role of echocardiography and coronary computed tomographic angiography in diagnosis. The successful surgical intervention underscores the importance of considering SVA in cases of angina pectoris and highlights the potential for effective treatment through surgical management. The report reinforces the need for vigilant diagnostic approaches in cardiovascular medicine.
As a contribution to the Journal of Cardiothoracic Surgery, this case report offers a valuable clinical perspective on a rare cardiovascular anomaly. It aligns with the journal's scope by providing insights into the diagnosis and surgical management of a complex cardiothoracic condition. The focus on angina pectoris and myocardial ischemia is pertinent to the journal's readership of surgeons and cardiologists.