Chest pain – Aortic dissection

FRCEM EXAM QuestionsCategory: March 2018Chest pain – Aortic dissection
FRCEM Intermediate Staff asked 10 months ago

A 68-year-old man is brought to hospital complaining of severe sharp chest pain which is radiating between his
shoulder blades. An ECG has been performed which is normal. A chest x-ray has been performed which is shown
below:

A. What is the most finding in this X-ray? (1 mark)
B. What is your diagnosis? (1 mark)
C. What is the investigation of choice? (1 mark)

1 Answers
FRCEM Intermediate Staff answered 10 months ago

A.
Widened mediastinum
abnormal aortic contour
aortic knuckle double calcium sign >5mm
pleural effusion (L>R)
tracheal shift
left apical cap,

B.
Acute Aortic Dissection.

C.
CT- Aorta