Natural History and Sequelae of Penetrating Aortic Ulcer

A man in his 70s with history of tobacco use and hypertension presented for transesophageal echocardiography after a recent diagnosis of ischemic stroke. This demonstrated a moderate right-to-left shunt on Valsalva release and no left atrial appendage thrombus. Assessment of the thoracic aorta revealed a complex penetrating aortic ulcer and saccular aneurysm with thrombus in the distal arch and proximal descending thoracic aorta (Figure). Computed tomography angiography confirmed the presence of multiple penetrating ulcerations with large saccular aneurysms.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research