TY - JOUR T1 - A catastrophic cause of chest pain JF - Clinical Medicine JO - Clin Med SP - 516 LP - 519 DO - 10.7861/clinmedicine.13-5-516 VL - 13 IS - 5 AU - Azeem S Sheikh AU - Amer Qureshi AU - Azhar A Khokhar Y1 - 2013/10/01 UR - http://www.rcpjournals.org/content/13/5/516.abstract N2 - 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. ER -