case_images: PMC4942518_01
case_images: ECG demonstrating normal sinus rhythm at 86 bpm. No other significant abnormalities were noted.
case_images: JCHIMP-6-31506-g001.jpg
case_images: PMC4942518_01_JCHIMP-6-31506-g001.jpg
case_images: F0001
case_images: Initial EKG showed normal sinus rhythm at 86 bpm, normal axis with no evidence of ST elevation or depression (Fig. 1).
case_images: CT angiogram of chest with contrast (a) transaxial and (b) coronal planes demonstrating a penetrating atherosclerotic aortic ulcer (blue arrow) with a mural hematoma approximately 2.3 cm in the largest transverse diameter and 1.25 cm in the largest thickness (blue arrow).
case_images: JCHIMP-6-31506-g002.jpg
case_images: PMC4942518_01_JCHIMP-6-31506-g002.jpg
case_images: F0002
case_images: CT angiogram of the chest with contrast (CTA) was obtained, which showed a protrusion of the medial wall of the descending thoracic aorta into a thickened aortic wall indicative of a penetrating atherosclerotic ulcer with IMH (Fig. 2a, b).