Pleuritic chest pain and fever: An unusual presentation of aortic dissection
- Author:
Mohamed Syarif Mohamed Yassin
;
Noorhida Baharudin
;
Anis Safura Ramli
;
Hilwati Hashim
- Publication Type:Case Reports
- Keywords:
Aortic dissection;
aortic dissection detection risk score;
chest pain;
elevated C-reactive protein
- From:Malaysian Family Physician
2019;14(1):47-52
- CountryMalaysia
- Language:English
-
Abstract:
It remains a challenge to diagnose aortic dissection in primary care, as classic clinical features are not
always present. This case describes an atypical presentation of aortic dissection, in which the patient
walked in with pleuritic central chest pain associated with a fever and elevated C-reactive protein.
Classic features of tearing pain, pulse differentials, and a widened mediastinum on chest X-ray were
absent. This unusual presentation highlights the need for a heightened level of clinical suspicion for
aortic dissection in the absence of classic features. The case is discussed with reference to the literature
on the sensitivity and specificity of the classic signs and symptoms of aortic dissection. A combination
of the aortic dissection detection risk score (ADD-RS) and D-dimer test is helpful in ruling out this
frequently lethal condition.
- Full text:2.2019my0031.pdf
