Tortuous thoracic aorta. Contained, oval outpouching of contrast along the right lateral aspect of the proximal ascending aorta communicating with the true lumen through a large opening, which extends inferiorly to the level of the sinus of Valsalva. Relatively subtle, higher-attenuation of the fluid rim surrounding and slightly above this aneursym sac.
Additional, similarly configured contained outpouching along the inferior left lateral aspect of the aortic arch, communicating with the true lumen through a large opening. Atherosclerosis of the right and left main coronary arteries which arise from the true lumen.
Large pericardial effusion with fluid tracking cranially into the pericardial recesses. Small left pleural effusion and trace right pleural effusion.