[Extensive aortic dissection and aneurysm of the left coronary trunk. 20-year spontaneous development]

A case is reported of dissection of the aorta in a lady of 35. The condition was complicated first by myocardial infarction and secondly by severe aortic incompetence which led, 20 years after the onset of the dissection, to the death of the patient from intractable heart failure. At post-mortem, an extensive dissection was found to involve the whole of the aorta and several of its branches, but did not involve the coronary arteries, which were normal except for the trunk of the left coronary; this was dilated. The natural history of dissections of the aorta is reviewed. The incidence, course and etiology of coronary aneurysms are also discussed.