Albany Medical Review - January 2002

A 74-year-old man with persistence of chest pain

Arthur Galoustian, MD

A 74-year-old man with a history of coronary artery disease who presented with complaint of severe chest pain, was treated initially for an acute coronary syndrome (including anticoagulation). Relative hypotension, persistence of pain on morphine, and questionable transthoracic echocardiogram; led to obtaining a contrast-enhanced computed tomography scan of the chest. A representative image of the computed tomography scan is shown below. What is your presumptive diagnosis?

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30.01.2002

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