PMC7569054_01
A chest X-ray on arrival. No obvious rib fractures were seen.
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Her chest X-ray showed subtle cardiomegaly and mediastinal widening which was interpreted as postural effect, and her pelvic X-ray did not show any fractures (Figure 1).
CT scan images. (A) An axial plane CT showing dissections in the ascending (black arrow) and the descending aorta. The aortic arch is strongly calcified. (B) The false lumens were filled with contrast media (black arrow). (C) A sagittal plane of the truncal CT showing dissection in the ascending aorta with a false lumen filled with contrast media (black arrow) and dissection in the descending aorta. The false lumen in the descending aorta was patent to the true lumen in the proximal part and filled with thrombus in the distal part (white arrow). (D) The flaps in the ascending aorta seem to be connected to the calcified aortic arch (black arrow). (E) The distal end of calcified aortic arch is attached to the flap in the descending aorta (white arrow).
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The dissection in the ascending aorta had a false lumen communicated with the true lumen (Figure 2A-D). In the descending aorta, the proximal part of the false lumen was stained with contrast media, and the distal part showed thrombus formation (Figure 2D and E).