title: A catastrophic cause of chest pain.
abstract: Chest pain can be a manifestation of aortic pathology and must be considered in any patient with a history of chest trauma, hypertension, atherosclerosis, connective tissue disorder and/or radiographically abnormal aortic contours. Acute intramural haematoma can resemble acute myocardial infarction and can be life-threatening if not correctly diagnosed. Electrocardiogram (ECG) must be carried out in all patients as it helps distinguish acute myocardial infarction (for which antiplatelets and anticoagulants may be life-saving) from intramural haematoma (for which these drugs may be detrimental). Other imaging modalities may be considered depending upon the clinical situation.
authors.affiliation: Department of Cardiology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex, UK.
authors.forename: Azeem S
authors.initials: AS
authors.lastname: Sheikh
authors.forename: Amer
authors.initials: A
authors.lastname: Qureshi
authors.forename: Azhar A
authors.initials: AA
authors.lastname: Khokhar
mesh_terms: D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery*; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D014057:Tomography, X-Ray Computed