PMC10155736_01
Anteroposterior view chest X-ray showing a mediastinal lesion (*).
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A chest X-ray was ordered and interpreted by radiology to be concerning for a left-sided mediastinal mass in the area of the thoracic aorta (Figure 1).
Suprasternal aortic notch POCUS showing a hyperechoic lesion (*) in a dilated descending aorta.
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To further evaluate the proximal aorta given the high clinical suspicion for pathology, a suprasternal aortic notch point of care ultrasound (POCUS) was performed demonstrating a dilated descending thoracic aorta with a contained mobile hyperechoic collection (Figure 2).
Computed tomography angiogram of the aorta showing a descending thoracic aortic aneurysm and contained aortic rupture. A) the aneurysm in the axial plane, B) the aneurysm in the coronal plane.
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Given the POCUS findings, the patient was emergently sent for a computed tomography angiogram of the aorta which revealed a 7 cm descending thoracic aortic aneurysm (TAA) with irregularity of the anterior lateral wall suspicious for a contained rupture (Figure 3).