Case and Plan:
HPI: 46-year-old female, who was initially hospitalized at the index care center with symptoms of chest pains, SOB, and vague abdominal pain. ACS and PE were ruled out. Initial CTA PE protocol showed non-gated images concerning for an isolated left renal artery aneurysm. Focused CTA Abdomen/Pelvis with contrast and US confirmed an isolated left renal artery aneurysm of ~2.9 x 2.1 cm on CTA and ~2.1 x 2.0 cm on US respectively. Focused renal imaging did not find imaging characteristics of FMD. Upon discharge the patient had no further chest pains or SOB but continues to have left flank pain that is described as constant, non-radiating, 5/10 at the worst. The patient denies any pain with urination or hematuria. The patient was rightly referred to Mount Sinai for further management of her renal artery aneurysm.
PMHx: Hypothyroidism, HTN, HLD, NIDDM
Social Hx: Former smoker
Medications: Synthyroid, Toprol, Glucophage, Lipitor