Fig. 7
From: Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!
A 55-year-old female with Staphylococcus aureus sepsis, cardiogenic shock, and pulmonary lesions concerning for septic emboli. Axial (a) non-ECG-gated chest CT showed hyperdense purulent pericardial effusion (black arrow in a) with a contrast filled outpouching at the aortic root (white arrow) and left pleural effusion (star). The contrast outpouching was not recognized by a non-cardiovascular imager. Follow-up axial (b) and coronal (c) high-pitch CT images (venous phase) after 1 month of treatment showed resolution of pericardial effusion but enlarged pseudoaneurysm (white arrow) exerting mass effect on the left anterior descending coronary stent. Surgical repair of the pseudoaneurysm with coronary artery bypass grafting was performed due to continued chest pain