Unruptured aneurysms of all sinus of Valsalva causing non-ST-elevation myocardial infarction

Abstract

A 36-year-old female patient was admitted with 1-hour history of chest pain and short of breath. Electrocardiogram displayed dynamic ST segment depression and T-wave inversion in precordial leads (V1–V6) (Fig. 1, panels A and B), and the serum level of cardiac troponin T was significantly elevated. Coronary angiography showed mild stenosis of left main coronary artery (panel C, arrowed) and normal left anterior descending, circumflex and right arteries (panels C and D). The multislice spiral CT revealed aneurysms of left-, rightand non-coronary sinus of Valsalva (panel E), and the proximal portion of left main coronary artery was displaced superiorly and compressed by the left sinus Valsalva aneurysm (panels F and G, arrowed). The sinus Valsalva aneurysms are generally isolated and are frequently involved in rightor non-coronary sinus of Valsalva [1,2]. There have been extremely rare reports of aneurysms arising from all sinuses of Valsalva, especially accompanied with acute myocardial infarction resulted from left sinus Valsalva aneurysm. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology (Shewan and Coats 2010;144:1–2).