A 22 year old man was found to have a 5.4 cm aortic root aneurysm upon screening echocardiogram. He had no Marfanoid features. His 19 year old brother had died suddenly of an acute ascending aortic dissection six weeks previously. A cardiology appointment was scheduled, but in the interim he developed transient chest, neck, and jaw burning. He was transferred pain-free from his local emergency room for further evaluation.

A computed tomographic (CT) scan with …