Images in emergency medicine: giant ascending aortic aneurysm dissection with hemopericardium.

BACKGROUND Acute chest pain represents a common presentation at emergency department. Aortic dissection in young patients, however, is fortunately rare. METHODS We report a case of giant ascending aortic aneurysm with Stanford type A aortic dissection in an otherwise well 22-year-old male patient. Operative aortic valve and root replacement was undertaken with favourable outcome. RESULTS Histopathologic examination of the resected aorta revealed acute on chronic inflammatory change with Langerhans type giant cells consistent with a diagnosis of giant cell aortitis. CONCLUSION While uncommon, emergencies of the aorta may present in young patients. Predisposing conditions are discussed.