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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 …
Patient consent Obtained.
Contributors SGA and SG were responsible for the drafting of the manuscript and TN, SGA, TKL and SG for the interpretation of the results.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.