Acute proximal aortic dissection penetrating into left atrium with a hypermobile thrombus

A 42-year old patient with suspected Marfan syndrome was admitted for examination of resting chest pain occurring intermittently for 1 week. Physical examination was completely normal with a normal blood pressure and present symmetrical upper extremities pulsation. ECG showed 2 mm ST-elevation in II, III, aVF, V4–6 leads. Selective coronarography was performed with a negative finding. On the basis of negative troponin test, myocardial infarction and myocarditis were excluded. Transthoracic …