CTICasesRuptured Descending Thoracic Aorta
Imaging findings
CT angiography in a patient with severe heart failure shows a ruptured descending thoracic aortic aneurysm associated with a massive left hemothorax and a dense layer of unmixed contrast pooling in the false lumen.
Key takeaways
Aortic rupture is a catastrophic event. In patients with cardiogenic shock or very low cardiac output, injected contrast can layer and pool within the false lumen or aneurysmal sac due to sluggish flow, which should not be misdiagnosed as acute thrombosis.
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