title: A case of thoracic aortic dissection presenting as lateral pleuritic chest pain.
abstract: 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.
authors.affiliation: Department of Endocrinology, Dudley Hospitals NHS Trust, Dudley, West Midlands, UK.
authors.forename: H S H
authors.initials: HS
authors.lastname: Hado
authors.forename: J H B
authors.initials: JH
authors.lastname: Scarpello
authors.forename: T
authors.initials: T
authors.lastname: Barton
authors.forename: H
authors.initials: H
authors.lastname: Scarborough
authors.forename: T A
authors.initials: TA
authors.lastname: Elhadd
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D010998:Pleurisy / Q000150:complications* / Q000175:diagnosis