An uncommon cause of chest pain in the emergency department of aortic aetiology

Image in interventional cardiovascular medicine: what is displayed on this image? ... And do not hesitate to comment on how you would treat this case!

We present the case of a 42-year-old woman evaluated at the emergency department with a chief complaint of sub-acute thoracic pain. Nine months prior to the evaluation, the patient presented infrequent episodes of thoracic pain described as oppressive located in the upper dorsal and precordial areas.She referred no evident triggers nor associated symptoms and pain responded to the use of over-the-counter analgesics. One week before her ED visit she noted worsening pain and sub-acute onset of dyspnea and dysphonia. She was initially evaluated in a community hospital where the suspicion for an acute aortic syndrome was made and the patient was referred to a cardiovascular center for further diagnostic work-up.On hospital admission, her temperature was 36.5°C, the pulse 90 beats per minute, the blood pressure 130/80 mm Hg, the respiratory rate 14 breaths per minute, and the oxygen saturation 95%. A contrasted angiotomography in coronal section was performed.

An image is worth a 1,000 words: participate in the quiz below to tell us what you see in this image!

Authors

Portillo Romero Alejandra Del Rocio¹, Nieto Rangel Sara Jacqueline¹, Araiza Garaygordobil Diego¹, Cuevas Medina Eric Norberto¹, Vega Servín Norman Said¹

1. Instituto Nacional de Cardiología Ignacio Chávez, CDMX, MEXICO