. A 83 year old woman with history of arterial hypertension, hypothyroidism, obesity, chronic renal insufficiency and incipient dementia was transferred to our hospital after complaints of chest pain. Investigation revealed a sacular ascending aortic aneurysm with the aneurysmal sac adjacent to the sternum. Due to her age, cognitive state and risk of sternal entry, she was refused for surgery. She was discharged after coronariography showed normal coronaries and other causes of chest pain were excluded. She is still alive and stable after 40 months, with no growth of aneurysm dimensions.