A 58-year-old man presented to hospital with atypical chest pain, chills, and fever. Although blood cultures grew Staphylococcus aureus, no primary source of infection was evident. Transesophageal echocardiography revealed false aneurysm formation in the lower thoracic aorta 38 cm from the incisors (A). The false aneurysm contained spontaneous echo contrast indicative of low flow. Extravasated blood surrounded the aorta. Angiography (B, arrow), contrast-enhanced CT (C, arrow), and three-dimensional reconstructed CT (D, arrow) confirmed the presence of an aneurysm arising from the posteromedial aspect of the aorta at the level of the 10th thoracic vertebra. The patient was treated with intravenous cloxacillin and taken to the operating room, where a leaking mycotic aneurysm was resected and a synthetic graft interposed. Intraoperative cultures of the aneurysm grew Staphylococcus aureus. The patient made an uneventful recovery and was left with no long-term sequelae.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC4-265, Houston, TX 77030.
- Copyright © 1997 by American Heart Association