Case Presentation

An 85-year-old male presented to the emergency room with recent onset of dyspnea and orthopnea. He had a known thoracic aortic aneurysm. On examination, he was found to be hypoxic and in atrial fibrillation with a rapid ventricular rate. A CT of the chest was performed, which demonstrated a large thoracic aortic aneurysm associated with a left pleural effusion, a large right main pulmonary artery embolus and a large pericardial effusion. The patient declined aggressive treatment.

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Robert S. Dieter, MD, RVT and Donald Thomas, MD^* From Interventional Cardiology, Vascular and Endovascular Medicine, Loyola University, Maywood, Illinois, and ^*Cardiac Surgery, Hines Veterans Administration Hospital, Hines, Illinois. The authors report no conflicts of interest regarding the content herein. Address for correspondence: Robert S. Dieter, MD, RVT, Vascular & Endovascular Medicine, Interventional Cardiology, Loyola University Medical Center, Director of Vascular Medicine and Peripheral Vascular Interventions, Assoc. Chief of Cardiology, Hines VA Hospital, 5000 S. 5th Ave., Hines, IL 60141. E-mail: rdieter@lumc.edu