Introduction:
Giant cell arteritis (GCA) is a chronic vasculitis of large- and medium-sized vessels that tends to affect women and the elderly. One population study describes a two-fold higher incidence among women with a mean age at the time of diagnosis of about 75 years1. The classic presentation of GCA is headache, temporal artery sequelae, and elevated inflammatory markers. While there is a known association between GCA and aortic dissection, no known studies or case reports have described patients who presented with acute-on-chronic thoracic aortic dissection. We describe a patient who presented with thoracic aortic aneurysm with acute-on-chronic dissection secondary to GCA underwent successful repair.