Rupture of huge thoracic aortic aneurysm in a young man: Case report and literature review

Abstract

Thoracic aortic aneurysms are considered more dangerous than abdominal aneurysms because they are often silent until rupture and, therefore, are more challenging to diagnose and have a high mortality rate. In addition, a thoracic aneurysm differs from an abdominal one in terms of causes and risk factors: the former is associated with the degeneration of the vessel's middle tunica, while the latter is related to atherosclerosis.

We report the case of the sudden death of a 20-year-old man, with no apparent risk factors and suffering only from a persistent cough for a month, in whom the autopsy revealed the rupture of a massive aneurysm of the ascending thoracic aorta. Blood leaked from the wall of the aorta into the pericardial sac, causing cardiac tamponade and the death of the young man. Histology demonstrated cystic medial degeneration with no other relevant features.

In this paper we discuss the mechanisms of aneurysm formation and report a review of the literature on similar cases, limited to ruptures of thoracic aortic aneurysms discovered post-mortem.