PMC5745711_01
Initial EKG in ED. Rate 108/min. Sinus tachycardia. Anterior, inferior lead ST elevation (QTc 455).
CRIC2017-1785410.001.jpg
PMC5745711_01_CRIC2017-1785410.001.jpg
fig1
ST elevation suggestive of anterior and inferior infarct (Figure 1). Serial troponins three times were normal.
CT chest with contrast showing 6 cm aortic root (yellow dotted line).
CRIC2017-1785410.002.jpg
PMC5745711_01_CRIC2017-1785410.002.jpg
fig2
CT chest showed 6 cm aneurysm of the aortic root and ascending aorta and aneurysm of the aortic arch 3.6 cm, without dissection (Figure 2).
Transesophageal echocardiography (midesophageal, long-axis view) showing massive dilation of ascending aorta. (a) Opening of the aortic valve; (b) closure of the aortic valve.
CRIC2017-1785410.003.jpg
PMC5745711_01_CRIC2017-1785410.003.jpg
fig3
TEE finding was consistent with 6.2 cm aneurysm, moderate to severe AR but no dissection (Figure 3).