Aortic diseases contribute to the high overall cardiovascular mortality rate. The Global Burden Disease 2010 project demonstrated that the overall global death rate from aortic aneurysm and aortic dissection has increased in the past decade. Guidelines on the diagnosis and treatment of aortic diseases emphasize rapid and efficacious diagnostic strategies. In this paper, we review the imaging of a man with a thoracic aortic aneurysm diagnosed in an outpatient clinic. An 81-year-old man presented with recurring sweating, dizziness, and syncope. He had hypertension since he was 60 years old, which was well controlled. Two years previously, he had episodes of presyncope, fainting, sweating, and blood pressure fluctuations, ranging from 160e170/100 mmHg to 80/40 mmHg. No intracranial lesions were noted in brain computed tomography. Myocardial perfusion scintigraphy for myocardial ischemia was negative and an echocardiogram showed no abnormalities in the left ventricular ejection fraction or wall motion. Magnetic resonance imaging of the neck revealed a huge dilation of the aortic arch with a peripheral thrombus (Fig. 1, arrows). A series of plain chest radiographs revealed a high aortic arch (Fig. 2) with progressive elongation (Fig. 3). Altogether, the results indicated a diagnosis of a thoracic aortic aneurysm (TAA). The patient underwent a thoracic endovascular aortic repair. Postoperatively, he had an embolic stroke and pulmonary infection. He was discharged after 3 months of hospitalization and followed up in an outpatient clinic.