The rupture of an azygos vein aneurysm is a very rare but catastrophic complication. Careful differential diagnosis of acute dyspnoea and thoracic pain in young patients is essential for effective and early management. We present the case of a young woman with a huge, spontaneously ruptured vena azygos saccular aneurysm, successfully repaired via median sternotomy under cardiopulmonary bypass.
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