RT Journal Article SR Electronic T1 A catastrophic cause of chest pain JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 516 OP 519 DO 10.7861/clinmedicine.13-5-516 VO 13 IS 5 A1 Azeem S Sheikh A1 Amer Qureshi A1 Azhar A Khokhar YR 2013 UL http://www.rcpjournals.org/content/13/5/516.abstract 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.