Aneurysms of the sinus of valsalva are rare and almost always originate from the right or non coronary sinuses. Unruptured, they normally remain clinically silent (detected by routine echocardiography) but can cause right ventricular outflow tract obstruction, aortic regurgitation and myocardial ischaemia from coronary artery compression.

Sinus of Valsalva aneurysm (SVA) is a rare congenital heart malformation of one or more of the aortic sinuses, consisting of a dilation that when unruptured is usually asymptomatic but when ruptured presents with progressive exertional dyspnea, fatigue, chest pain and that can lead to congestive heart failure if left untreated.

A ruptured sinus of Valsalva aneurysm results in a communication between the aortic sinus and the atrium or right ventricle. The abnormality is often congenital, but may also be acquired from endocarditis or trauma. The defect is adjacent to the aortic valve and may be associated with a leak in the valve.

Sinus of Valsalva aneurysms most commonly affect the right coronary cusp and are associated with a high incidence of rupture. Rupture of the sinus of Valsalva aneurysm can present with a wide array of symptoms ranging from mild atypical chest pain and exertional dyspnoea to cardiogenic shock and sudden cardiac death.