Presentation
Congestive heart failure.
Patient Data
Age: 35 years
Gender: Male
From the case:
Massive ascending thoracic aortic aneurysm
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Massive fusiform ascending aortic aneurysm involving the root/sinuses of Valsalva, 8.8 cm AP.
Left ventricular dilation.
Brachiocephalic ectasia.
Case Discussion
While undiagnosed, this patient almost certainly has an underlying connective tissue disorder to account for the formation of his massive aneurysm at such a young age (such as Marfan, Ehlers Danlos, or Loeys Dietz1). No evidence of rupture. Ectasia of the brachiocephalic artery supports a connective tissue disorder.
For aneurysm greater than 6 cm, the risks are as follows:
- rupture 3.7% per year
- rupture or dissection at 6.9% per year
- death at 11.8%
- and death, rupture, or dissection at 15.6% per year2
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