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Mrs. Z, a 52-year-old female, visited the doctor because her granddaughter heard a loud heartbeat above her belly button using a toy stethoscope. Mrs. Z has a history of smoking for 33 years and high cholesterol. Her blood pressure is elevated and she has a pulsating mass above her belly button. Case presentation of Mrs. Z. Gender, female. Age, 52. Patients report. Granddaughter used toy stethoscope. Heard loud heartbeat above navel. Smoking and medical history. Smoking history. One to two packs per day for 33 years. Medical history. History of high cholesterol and last period was three months ago. Vital signs. Blood pressure. 176 over 94. Heart rate, 88 with occasional PVCs. Height, 52. Weight, 165 pounds. Physical examination. Pulsating mass above umbilicus. Upper left of midline, palpable when supine.