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Emerg Med J doi:10.1136/emermed-2012-202162
  • Images in emergency medicine

Roller coasters: a source of fun and tears

  1. Scot Garg1
  1. 1Cardiology Department, Royal Blackburn Hospital, Blackburn, UK
  2. 2Cardiovascular Research Group, University of Manchester, Manchester, UK
  3. 3Radiology Department, Royal Blackburn Hospital, Blackburn, UK
  1. Correspondence to Dr Scot Garg, Cardiology Department, Royal Blackburn Hospital, Haslingden Road, Blackburn BB2 3HH, UK; scot.garg{at}elht.nhs.uk
  • Received 14 November 2012
  • Revised 14 November 2012
  • Accepted 21 November 2012
  • Published Online First 12 January 2013

A previously fit 43-year-old man presented with sudden onset, severe, tearing intrascapular chest pain one day after visiting an amusement park where he had engaged in a number of high-speed rides. Examination was unremarkable apart from a prominent diastolic murmur; blood pressure was 144/61 mm Hg. There was biochemical evidence of acute renal failure and microscopic haematuria. His electrocardiogram showed non-specific infero-lateral T-wave changes. Urgent trans-thoracic echocardiography (figure 1) demonstrated evidence of a …