A saccular aneurysm of the ascending aorta as diagnosed by conventional echocardiography.

摘要

A 57-year-old woman presented with worsening fatigue, dyspnoea and chest discomfort. A year ago she experienced an episode of chest pain accompanied by tropo-nin elevation that had been considered an acute coronary syndrome. However, coronary angiography proved unremarkable. Since then, the aforementioned symptoms emerged gradually. Chest X-ray revealed a bulge of the ascending aorta contour that was not present a year ago (Panel A). Routine transthoracic echocar-diography, including the supraster-nal view, was morphologically unremarkable. However, from the parasternal long-axis view through the second left intercostal space, a saccular aneurysm >5 cm in diameter could easily be seen (Panels 8 and C; see Supplementary material online, Video 51). Obviously, the aneurysm (AN) eliminated the existence of air behind the anterior chest wall making it echographically visible, along with most of the distal ascending aorta (AA), arch and proximal descending aorta (DA). The CT scan confirmed the presence of a partially thrombosed aneurysm (Panel D). The rest of the aorta was not dilated.