Thoracic Aortic Aneurysm

Case Synopsis

An 80-year-old man with previous abdominal aortic aneurysm (AAA) repair presents with abrupt-onset back pain starting 1 hour ago. He is alert, diaphoretic, tachycardic, and hypertensive. He is given oxygen, nitroglycerin, and morphine. He was found to have a dissecting thoracoabdominal aortic aneurysm (TAAA) on a computed tomography (CT) scan. There is absence of blood flow to the left kidney. Large peripheral intravenous access was placed, and with blood pressure control his pain resolved. He has multiple medical problems including hypertension, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and diabetes.