PMC6886635_01
(A) Chest x-ray with right deviation of the mediastinum, a prominent aortic arch and left pleural effusion. (B) Aneurysm of the thoracic aorta (white arrow) with distal onset at the emergence of the supra-aortic vessels. (C) Mural thickening at the level of the aortic arch, with several spontaneously dense laminar areas suggesting a haematoma (yellow arrow) of the aneurysm wall, and left pleural effusion compatible with haemothorax
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f1-1277-1-9746-1-10-20191029
Before thrombolytic treatment with alteplase was initiated, a chest x-ray was conducted and showed right deviation of the mediastinum with a prominent aortic arch and left pleural effusion (Fig. 1A). Therefore, it was decided to perform a thoracic CT scan which revealed a dissecting aneurysm of the thoracic aorta, with distal onset at the emergence of the supra-aortic vessels (Fig. 1B) and exuberant mural thickening at the level of the aortic arch, with several spontaneously dense laminar areas suggesting haematoma of the aneurysm wall, as well as massive left pleural effusion compatible with haemothorax (Fig. 1C).