title: Use of heparin in aortic dissection: beware the misdiagnosis of acute pulmonary embolism.
abstract: We present a case which highlights the diagnostic difficulties between a Stanford type A aortic dissection (AD) and a pulmonary embolism (PE) and the impact it has on subsequent management. A 75-year-old man presenting with chest pain, shortness of breath and dizziness was initially suspected of having a PE and started on low-molecular-weight-heparin (LMWH). The patient was correctly diagnosed afterwards with CT of the chest to have an aortic dissection. The detrimental use of LMWH may have caused a propagation of the dissection and delayed surgical intervention of an acutely life-threatening condition. When the diagnosis is unclear, the early use of CT can help differentiate AD from PE. This in-turn can guide the management as well as the use of LMWH, which should be avoided until the correct diagnosis is confirmed.
authors: Keele University Medical School, Stoke-on-Trent, UK. yashashwisinha@hotmail.com
authors: Yashashwi
authors: Y
authors: Sinha
authors: Mahdi
authors: M
authors: Saleh
authors: Daniel
authors: D
authors: Weinberg
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D002637:Chest Pain / Q000175:diagnosis; D003951:Diagnostic Errors; D004244:Dizziness / Q000175:diagnosis; D004417:Dyspnea / Q000175:diagnosis; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D006495:Heparin, Low-Molecular-Weight
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