PT  - JOURNAL ARTICLE
AU  - Jason M Tarkin
AU  - James H F Rudd
AU  - David R Jayne
AU  - Rosemary A Rusk
AU  - Deepa Gopalan
TI  - An unusual finding in a 57-year-old woman with new onset hypertension and a diastolic murmur
AID  - 10.1136/heartjnl-2016-309661
DP  - 2016 Nov 01
TA  - Heart
PG  - 1762--1762
VI  - 102
IP  - 21
4099  - http://heart.bmj.com/content/102/21/1762.short
4100  - http://heart.bmj.com/content/102/21/1762.full
SO  - Heart2016 Nov 01; 102
AB  - Clinical introduction A 57-year-old woman presented to our clinic with breathlessness brought on while walking uphill. She had been recently diagnosed with systemic hypertension. There was no known family history of cardiac disease, or prior smoking habit. On examination, pulse was 73 bpm and blood pressure 155/73 mm Hg, which was asymmetrical in her arms. Auscultation revealed a readily audible early diastolic murmur in the aortic area and bilateral subclavian bruits. ECG showed sinus rhythm with no abnormality. Transthoracic echocardiography demonstrated mild-to-moderate aortic regurgitation, and normal left ventricular size and function. The ascending aorta was mildly dilated (41 mm), with para-aortic thickening noted. Owing to the abnormal appearance of the aortic wall, cardiac MRI, and subsequently 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scan was performed (figure 1).Question Which complication of the underlying disease is evident in figure 1, panel C? Aortic aneurysmAortic dissectionAortic thrombusCoronary artery aneurysmCoronary sinus fistula