Myocardial infarct simulating an acute aortic dissection MSCT differential diagnosis of a congenital pericardial abnormal condition associated with coronary artery anomal origin, never described in literature

We report the case of a patient with a myocardial infarct whose clinical and multislice spiral computed tomography (MSCT) presentation could easily be mistaken for that of an acute aortic dissection (AAD) or an intramural hemorrhage (IMH). He had an aberrant high extended superior pericardial recess associated with an anomalous origin of the right coronary artery from the left sinus of Valsalva. It was absolutely necessary to exclude other mediastinal low attenuation masses immediately. At the best of our knowledge it is the first case reported in the literature of a congenital aberrant pericardial recess with these features.