Aneurysms arising from a ruptured left coronary sinus of Valsalva are rare cardiac anomalies. Aneurysms from the Sinus of Valsalva may be congenital or acquired. We present the case of a 38-year old Asian female with Takayasu's arteritis who presented with chronic chest pain and back pain with recent heart failure symptoms. 2D echocardiogram and CT aortogram revealed findings consistent with a ruptured left coronary Sinus of Valsalva forming an aneurysm causing possible compression of the left coronary circulation. Early surgical repair is the treatment of choice in these cases. Immediate surgical management is contemplated for the patient.