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Case Reports
. 2021 Aug;80(8):190-194.

Chronic Cough as a Presenting Symptom of a Giant Thoracic Aortic Aneurysm: A Case Report

Ali Hussain  1 , Zhaohui Arter  1 , Alvin C Yiu  1
Affiliations
Case Reports

Chronic Cough as a Presenting Symptom of a Giant Thoracic Aortic Aneurysm: A Case Report

Ali Hussain et al. Hawaii J Health Soc Welf. 2021 Aug.

Abstract

Chronic cough has a broad differential, and thoracic aortic aneurysm (TAA) is a rare but potentially life-threatening etiology. We present a giant arch TAA in a non-dyspneic, Pacific Islander man with significant tobacco-use history who presented with chronic cough with no acute pulmonary process noted on imaging. Given the high mortality rates associated with thoracic aortic aneurysms, the purpose of this report is to highlight the importance of keeping TAA as a rare differential for chronic cough, particularly when caring for patients with elevated risk. Recognition of patients with thoracic aortic disease who have a class I indication for surgical intervention (meaning there is evidence or general agreement that surgery will be beneficial, useful, and effective) as well as prompt evaluation of their anatomical landmarks in the perioperative period is critical. Imaging and, in particular, computed tomography remain the optimal modalities to screen for thoracic aortic disease.

Keywords: Aneurysm; Cardiology; Cardiothoracic Surgery; Internal Medicine; Thoracic Aortic Disease.

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Figures

Figure 1.
Figure 1.
Outpatient Chest-X ray (Posterior-Anterior and Lateral) Demonstrating A Widened Mediastinum With A Probable Thoracic Aortic Aneurysm.
Figure 2.
Figure 2.
Non-contrast Computed Tomography Scan of the Chest. The axial view (A) and the sagittal view (B) show the 8.3-cm-diameter saccular aneurysm extending from the lateral anterior aspect of the aortic arch. Another axial view (C) demonstrates pulmonary vascular compression.
Figure 3.
Figure 3.
Gated Computed Tomography Scan of the Aorta. Scan with contrast shown in axial view (A and B), sagittal view (C), and coronal view (D) showing a large, saccular aneurysm involving the proximal aspect of the descending aorta just distal to the takeoff of the left subclavian artery, which measures approximately 7.7 cm x 7.9 cm x 8.1 cm in size (see labels).
Figure 4.
Figure 4.
Three-Dimensional Computed Tomography Reconstruction of the Saccular Aortic Aneurysm. Coronal view (A) and sagittal view (B).
See this image and copyright information in PMC

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