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Penetrating atherosclerotic ulcer: another case of the ‘great pretender’
  1. Philippa Howlett1,
  2. Venkatachalam Chandrasekaran2,
  3. Tuan Peng Chua1
  1. 1 Cardiology Department, Royal Surrey County Hospital, Guildford, UK
  2. 2 Cardiothoracic Surgery, St George's Hospital, London, UK
  1. Correspondence to Dr Philippa Howlett, Cardiology Department, Royal Surrey County Hospital, Guildford GU2 7XX, UK; philippah{at}

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A 57-year-old woman presented with acute retrosternal discomfort. An ECG demonstrated diffuse T wave inversion and she was treated for an acute coronary syndrome. Upon further review, CT aortography was arranged. This was reported as showing aortic wall thickening consistent with aortitis (figure 1). Subsequently the patient deteriorated. …

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  • Contributors PH wrote the initial manuscript. It has subsequently been reviewed and updated by TPC and VC. PH, TPC and VC were involved in the care of the patient.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.