Abstract

A male patient aged 68 years, arrived to the emergencyoutpatient clinic with a transient loss of conscience, following acute onset chest and back pain. Physical examination of the patient revealed cyanosis in the head and neck region and distension of neck veins. A dense effusion around the cardiac spaces was observed during the echocardiographic examination. Thoracoabdominal computed tomography with contrast did not reveal findings supporting dissection. The clinical condition of the patient improved significantly after the drainage of 650 ml of fluid. On repeat echocardiography, a double contour in the ascending aorta, 2 cm proximal to the valvular level and separated by a hypodense area was observed. The patient was operated and a Dacron graft was inserted to the ascending aorta along the 6 cm segment starting from 2 cm proximal to the valvular level. The patient was discharged upon full recovery.