Hemopericardium from retrograde dissection of an abdominal aortic aneurysm

Atherosclerotic abdominal aortic aneurysms rarely result in significant aortic dissection, and it is even more unusual to see marked proximal extension of such a dissection. We report the case of an 82-year-old man whose fatal dissection and hemopericardium originated in an atherosclerotic abdominal aortic aneurysm. This is apparently the third such case to be reported. Accurate angiographic identification of the site of intimal disruption, whether intrathoracic or intra-abdominal, is essential for planning proper therapy.