Background: A sinus of Valsalva aneurysm is a rare cardiac anomaly which may be acquired or congenital. The main associated symptoms are conduction disturbances, myocardial ischemia, and syncopes.Case Presentation: In this report we describe a 52-year-old Albanian woman from Kosovo with an unruptured aneurysm of 74×60 mm of the noncoronary sinus of Valsalva presenting dyspnea, jugular distension, and tachycardia due to cardiac compression. She underwent successful closure of the orifice and sinus remodeling with a Dacron patch.Conclusion: To the best of our knowledge this is the largest reported isolated unruptured aneurysm of the coronary sinus causing severe compression of the cardiac chambers undergoing successful surgical correction. [ABSTRACT FROM AUTHOR]