Chest pain in an adolescent revealing a sinus of Valsalva aneurysm secondary to Takayasu arteritis

A 15-year-old female presented with exertional chest pain and near-syncope. Imaging revealed a large left sinus of Valsalva aneurysm compressing the left coronary artery. She underwent successful surgical repair. Intraoperative and pathologic findings confirmed Takayasu arteritis. This case highlights a rare aetiology of cardiac chest pain in adolescents and underscores the importance of evaluating for an underlying vasculitis when a sinus of Valsalva aneurysm is identified.