Rupture of a Left Sinus of Valsalva Aneurysm With Coronary Compression: A Rare Cause of Ischemic Chest Pain

We describe the case of a 52-year-old man presenting with chest pain and ischemic electrocardiogram changes. He was initially prepared to undergo primary percutaneous intervention, but echocardiography revealed pericardial effusion and computed tomography confirmed the diagnosis of rupture of a left sinus of Valsalva aneurysm. Emergency surgery was performed, and the aneurysm was repaired using a composite Dacron-Aortic homograft patch. The patient had a good postoperative recovery. This case report demonstrates the difficulty dealing with the minority of patients presenting with presumed ST elevation myocardial infarction, but for whom the life-saving treatment is surgery.