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Initial Chest X-ray: Cardiac and mediastinal silhouette enlarged, endotracheal tube and right thoracostomy tube in place.
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An initial chest x-ray demonstrated a widened cardiac and mediastinal silhouette with further computed tomography angiography (CTA) imaging that demonstrated multiple bilateral rib fractures, pulmonary contusions, bilateral hemothoraces, and a retrosternal mediastinal contusion without evidence of dissection, aneurysm, or aortic injury (Fig. 1).
3D Coronary CT Angiogram Reconstruction: Demonstrating large LAD pseudoaneurysm with communication to the right ventricle.
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Coronary CTA was able to define a lesion posterior to the LAD that filled with contrast and became continuous with the right ventricle (Fig. 2).