Chest echocardiography as a tool for finding penetrating atherosclerotic ulcers in a patient with aortic intramural haematoma

A 78-year-old female with a history of aphasia presented with sudden onset of cold sweating suspected to be related to thoracic penetrating atherosclerotic ulcers (PAU) with a 3.8-cm intramural haematoma (A), which was being treated conservatively. A left-sided pleural effusion was noted and chest echocardiography showed an enlarged intramural haematoma and a new PAU (B). The repeat aortic computed tomography found the PAU and saved her life. A 78-year-old female with a history of aphasia presented with sudden onset of cold sweating suspected to be related to thoracic penetrating atherosclerotic ulcers (PAU) with a 3.8-cm intramural haematoma (A), which was being treated conservatively. A left-sided pleural effusion was noted and chest echocardiography showed an enlarged intramural haematoma and a new PAU (B). The repeat aortic computed tomography found the PAU and saved her life. Reviewer information European Journal of Cardio-Thoracic Surgery thanks Luca Di Marco and the other, anonymous reviewer(s) for their contribution to the peer review process of this article.