Author + information
- Received December 29, 2012
- Accepted January 8, 2013
- Published online July 30, 2013.
- Bhupinder Singh, MD,
- Ravindran Rajendran, MD,
- Yadvinder Singh, MD,
- Vivek Singla, MD,
- Ravindranath K. Shankarappa, MD, DM and
- Manjunath C. Nanjappa, MD, DM
A 55-year-old man had left hemiparesis 1 month earlier, followed by progressive swelling and dilated nonpulsatile veins over the chest, neck, and upper arm (A, arrows) along with a pulsatile swelling over the right infraclavicular and parasternal area. A chest x-ray (B) showed a widened superior mediastinum with a “figure of 8” appearance. Transthoracic echocardiogram showed a dilated left ventricle (LV) with severe aortic regurgitation (G, Online Video 1). The ascending aorta (AA) was aneurysmally dilated, with a mobile thrombus (asterisk) attached to its wall (E, Online Video 2). Bicaval view (F, Online Video 3) showed superior vena caval (SVC) compression as evident by the turbulent flow into the right atrium (RA). Contrast-enhanced computerized tomography of the thorax (C and D) confirmed an ascending aortic aneurysm (measuring 81 mm) with calcific specks in its wall, compressing the SVC. Treponema pallidum hemagglutination test was positive. Before a surgery could be planned, the patient had another stroke and succumbed. Depending upon the segment involved, luetic aortic aneurysms can manifest variedly (1). Ao = aorta; DA = descending aorta; IVC = inferior vena cava; LA = left atrium; MPA = main pulmonary artery; RPA = right pulmonary artery.
- Received December 29, 2012.
- Accepted January 8, 2013.
- American College of Cardiology Foundation