Ascending aortic aneurysm

Case contributed by Abdallah Alqudah
Diagnosis certain


Middle aged patient presented with vague abdominal pain.

Patient Data

Age: 45 years
Gender: Male

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.

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