A necropsy specimen from an elderly woman who died suddenly after having severe back pain suspicious of aortic dissection. It demonstrates a penetrating atherosclerotic plaque (upper left) providing communication from the aortic lumen to an adjacent medial hematoma (bottom). An aortogram had been negative for dissection, but transesophageal echocardiography revealed the medial hematoma.
(From Lindsay J Jr et al. Diseases
of the aorta. In: Schlant RC, Alexander AW, Lipton MJ, eds. Diagnostic
Atlas of the Heart. New York: McGrawHill, 1996:321. Reproduced with
permission from the publisher and authors.)