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“Question mark” aorta
  1. K M Chow,
  2. W H Fung,
  3. C C Szeto
  1. 1Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China
  1. Correspondence to:
 Dr C C Szeto, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; 
 ccszeto{at}cuhk.edu.hk

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Answers onp 123.

An 83 year old woman with dementia was admitted to our hospital with cough and febrile illness. Her past medical history included previous cholecystectomy and latent syphilis, for which she had a full course of penicillin treatment three years previously in another hospital. Examination revealed no aortic regurgitation. A routine chest radiograph (fig 1) showed a shadow at right lower lung field. A left lateral chest radiograph showed a tortuous thoracic aorta resembling a question mark (fig 2).

Figure 1

Plain chest radiograph with abnormal shadow (arrow).

Figure 2

Plain radiograph (lateral view) of the chest, showing a “question mark” aorta.

QUESTIONS

  1. What is the most likely diagnosis and how do you confirm your suspicion?

  2. What are the other manifestations of this condition in the same system?

  3. What are the principles of management in this condition?

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