Sinus of Valsalva aneurysm presenting as myocardial infarction during dobutamine stress test.

We report a patient with an undiagnosed left sinus of Valsalva aneurysm who, during a dobutamine stress test, had myocardial injury and subsequent infarction. Cardiac catheterization revealed an expanding sinus of valsalva aneurysm compressing the circumflex coronary artery. The clinical manifestations of sinus of Valsalva aneurysm are discussed. This report heightens awareness of the possible effects of the pharmacologic stress test.