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Case Reports
. 2024 Oct-Dec;25(4):270-274.
doi: 10.4103/heartviews.heartviews_100_24. Epub 2025 May 10.

A Rare Case of Sudden Death due to Rupture of Saccular Descending Thoracic Aortic Aneurysm with Dissection

Jayeshkumar Kanani  1 , Kunjan Modi  1
Affiliations
Case Reports

A Rare Case of Sudden Death due to Rupture of Saccular Descending Thoracic Aortic Aneurysm with Dissection

Jayeshkumar Kanani et al. Heart Views. 2024 Oct-Dec.

Abstract

Ruptured descending thoracic aortic aneurysm (DTAA) is a rare event and remains asymptomatic in over 95% of cases, often leading to the under-detection of most thoracic aortic aneurysms (TAAs) unless incidentally discovered during routine imaging, medical examinations, or autopsy following sudden death. This case report presents a 56-year-old male with a history of hypertension and diabetes mellitus who was managed with regular medication, collapsed suddenly, and was found unconscious. Emergency medical services declared him dead on arrival. An autopsy examination disclosed 2750 g of blood in the left pleural cavity and a 2.5 cm transverse tear in a saccular aneurysm on the descending thoracic aorta with aortic dissection (AD). Histopathological analysis confirmed necrosis, fibrosis, and a mixed inflammatory infiltrate at the rupture site, with features consistent with healed myocardial infarction and grade VII atherosclerosis. This case underscores the importance of recognizing the silent yet fatal nature of saccular aneurysms in the descending thoracic aorta.

Keywords: Aortic aneurysm; aortic dissection; aortic rupture; cardiovascular emergency; descending thoracic aortic aneurysm; hypertension; saccular aneurysm; thoracic aortic disease.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
View from left pleural cavity showing the ruptured segment of a descending thoracic aortic aneurysm with surrounding hemorrhage and tissue discoloration
Figure 2
Figure 2
Confirmation of rupture by insertion of a spatula from the lumen, viewed from the posterior aspect
Figure 3
Figure 3
Saccular aneurysm over descending thoracic aorta with whole heart and aorta
Figure 4
Figure 4
Cut section from the heart to descending thoracic aorta showing internal view of aorta and aneurysm site
Figure 5
Figure 5
Transverse cut of aorta at rupture site showing thinning of aneurysm wall with splitting of wall into two layers and presence of mural thrombus
Figure 6
Figure 6
Closer view of internal aspect of rupture site showing the dissection of wall with multiple openings and blackish area
Figure 7
Figure 7
Section from aneurysm rupture site (a), wall of aneurysm (b), healed myocardial infarction (c), aortic calcification (d)
See this image and copyright information in PMC

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