[Hematothorax after sudden chest pain].
METHODS
A 75-year-old woman was admitted to hospital because of the sudden onset of acute chest pain and dyspnea after defecation.


METHODS
The initial working diagnosis was pulmonary embolism because of the clinical findings, laboratory results of elevated fibrin breakdown products and abnormal lung scintigraphy. However, persistent hemorrhagic pleural effusion on contrast enhanced computed tomography and magnetic resonance imaging subsequently revealed imminent rupture of the aorta from penetrating ulceration of the aorta with surrounding intramural hematoma.


METHODS
Immediate implantation of an aortic stent-graft stopped leakage from the aorta and stabilized the patient's hemodynamic state. At follow up three months later the patient was without thoracic or cardiac symptoms.


CONCLUSIONS
After exclusion of an acute coronary syndrome computed tomography imaging should always be performed in case of acute chest pain with no established cause. Interventional stent-graft placement can be an efficacious treatment option for emergency repair of imminent rupture in the descending aorta.
Kleinfeldt
T
T
Universität Rostock, Klinik und Poliklinik für Innere Medizin-Abteilung Kardiologie, Ernst-Heydemannstr. 6, 18055 Rostock. tilo.kleinfeldt@gmx.de
Rehders
T C
TC
Nienaber
C A
CA
Ince
H
H
Schneider
H
H
Virchow
J C
JC
D000208:Acute Disease; D000368:Aged; D000800:Angioplasty, Balloon; D001013:Aorta, Thoracic / Q000473:pathology; D001018:Aortic Diseases / Q000175:diagnosis* / Q000628:therapy; D001019:Aortic Rupture / Q000175:diagnosis* / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D002637:Chest Pain / Q000209:etiology*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000628:therapy; D006491:Hemothorax / Q000209:etiology*; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis; D012680:Sensitivity and Specificity; D015607:Stents; D014456:Ulcer / Q000175:diagnosis / Q000628:therapy