PT - JOURNAL ARTICLE AU - Azeem S Sheikh AU - Amer Qureshi AU - Azhar A Khokhar TI - A catastrophic cause of chest pain AID - 10.7861/clinmedicine.13-5-516 DP - 2013 Oct 01 TA - Clinical Medicine PG - 516--519 VI - 13 IP - 5 4099 - http://www.rcpjournals.org/content/13/5/516.short 4100 - http://www.rcpjournals.org/content/13/5/516.full SO - Clin Med2013 Oct 01; 13 AB - 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.