Presentation
Middle aged patient presented with vague abdominal pain.
Patient Data
Initial chest x-ray showed widening of the mediastinum.
There is calcified atherosclerotic changes of the thoracic aorta with severe 7.5 x 7.4 cm aneurysmal dilatation seen at the most proximal part of the ascending thoracic aorta (Including the origin of main coronary arteries), not reaching the arch associated with a penetrating ulcer of the mid aortic arch.
Minimal pericardial effusion is noted.
Case Discussion
This is a 45 year old male patient previously healthy presented with severe abdominal pain, admitted through the ER as a case of AF and signs of acute coronary syndrome.
The widened mediation seen in the initial chest x-ray in addition to the signs of acute coronary syndrome suggests vascular (namely aortic) cause.
CTA was done and showed aneurysmal dilatation of the ascending aorta.