Penetrating atherosclerotic ulcer of the aorta.
OBJECTIVE
To describe a case of penetrating atherosclerotic ulcer of the aorta with a review of its natural history, diagnosis and management.


METHODS
An elderly patient with a history of hypertension presented to the emergency room with the sudden onset of severe chest pain radiating to the back. The electrocardiogram showed left ventricular hypertrophy; the chest radiograph revealed mediastinal widening. Computed tomography was suspicious for a mediastinal hematoma without aortic dissection. Transesophageal echocardiography was also negative for dissection. An aortogram revealed a penetrating atherosclerotic ulcer of the descending thoracic aorta. The patient underwent successful resection and repair of the lesion.


CONCLUSIONS
Penetrating atherosclerotic ulcer of the aorta is a potentially lethal lesion that must be promptly diagnosed and treated.
Samal
A K
AK
Department of Cardiology, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121, USA.
White
C J
CJ
Kot
J B
JB
D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000601:surgery; D001027:Aortography; D001161:Arteriosclerosis / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery