© 2005 BMJ Publishing Group Ltd, and British Association for Accident and Emergency Medicine
CASE REPORT
A case of thoracic aortic dissection presenting as lateral pleuritic chest pain
1 Department of Endocrinology, Dudley Hospitals NHS Trust, Dudley, West Midlands, UK
2 Department of Diabetes and Endocrinology, North Staffordshire Hospitals NHS Trust, Stoke-on-Trent, UK
Correspondence to:
Correspondence to:
Dr T A Elhadd
Department of Medicine, King Faisel Specialist Hospital and Research Centre, PO Box 40047, Jeddah 21499, Kingdom of Saudi Arabia; tarikelhadd{at}aol.com
An unusual presentation of thoracic aortic dissection in a 73 year old man is described. He was admitted to hospital with severe left sided pleuritic chest pain. Examination on admission was normal apart from minor tenderness on palpation of the left lower chest wall. Chest x ray showed cardiomegaly with right lung shadowing, and ventilation/perfusion scan was negative. Spiral computed tomography done on the fourth day showed a false lumen on the ascending aorta. He underwent surgery but deteriorated postoperatively because of intrathoracic bleeding and developed cardiac tamponade from which resuscitation was not possible.
Keywords: aortic dissection; chest pain; pulmonary embolism; chronic bronchitis
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