Compression of left ventricle by a rare giant unruptured sinus of Valsalva aneurysm

A 60-year-old previously healthy woman was admitted with exertional dyspnea. She was a non-smoker and -drinker. Physical examination was insignificant, except for a soft early diastolic murmur. Further examination was performed. Blood tests and electrocardiogram were normal. Transesophageal echocardiography revealed a giant unruptured left sinus of Valsalva aneurysm (SVA) with spontaneous echo contrast, which severely compressed the left ventricle (Fig. 1, arrow, Video 1, 2). The 64-multidetector computed tomography angiogram with iodinated contrast injection was used to demonstrate the giant aneurysm with a maximal diameter of 8.7 cm, and the left main coronary artery was not involved (Fig. 2)