A 61-year-old man with cough and abnormal chest x-ray

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We present a case of a 61-year-old male smoker presenting with complaints of nonproductive cough and flulike symptoms. The chest x-ray revealed an enlarged mediastinal silhouette and no evidence of pneumonia. A computerized axial tomography scan was done, which demonstrated a very large thoracic aortic aneurysm with evidence of a hyperattenuating crescent sign, indicative of impending rupture. The patient denied chest and abdominal pain. He went to the operating room and had repair of the aneurysm.

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