title: Respecting symptoms in thoracic aortic aneurysm management: a case of symptomatic necrotizing granulomatous aortitis.
abstract: A 41-year-old woman presented with chest pain of unclear etiology in the setting of a mildly dilated ascending aorta. Computed tomography angiography showed an aorta with an irregular contour and an aneurysm of 4.5 cm. There was no radiographic evidence of rupture or dissection. The patient was taken to the operating room and was found to have severe aortitis with marked localized wall thinning at imminent risk of aortic rupture. Aortic pathology demonstrated necrotizing granulomas of noninfectious etiology. This case illustrates the importance of respecting symptoms in surgical decision making for thoracic aortic aneurysms that may not meet standard interventional criteria.
authors.affiliation: Aortic Institute, Yale-New Haven Hospital, New Haven, Connecticut.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Kuzmik
authors.forename: Adam X
authors.initials: AX
authors.lastname: Sang
authors.forename: Guoping
authors.initials: G
authors.lastname: Cai
authors.forename: Maryann
authors.initials: M
authors.lastname: Tranquilli
authors.forename: John A
authors.initials: JA
authors.lastname: Elefteriades
keywords: aortic aneurysm; aortic operation; aortic pathology