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Image challenge
Mottled skin of the abdominal wall
  1. Wei-Jing Lee,
  2. Chien-Chin Hsu
  1. Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan
  1. Correspondence to Dr Wei-Jing Lee, Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan; saab931103{at}yahoo.com.tw

https://doi.org/10.1136/emermed-2018-207498

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    Case introduction

    A 49-year-old man with hypertension under medical control presented to the ED with sudden chest pain, diaphoresis and dyspnoea. On arrival, low blood pressure were noted. His abdomen is showed in figure 1. ECG showed no ST elevation.

    Figure 1

    Abdominal wall appearance.

    Questions

    What is the most likely diagnosis?

    1. Pulmonary embolism.

    2. Myocardial infarction.

    3. Aortic dissection type A.

    4. Myocarditis. …

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    Footnotes

    • Contributors Both authors provide equal contribution to this paper.

    • Competing interests None declared.

    • Patient consent Obtained.

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