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Unusual presentation of more common disease/injury
CASE REPORT
Pushing beyond the limit: a novel clinical sign of thoracic aortic dissection
  1. Thomas Meredith,
  2. Pankaj Jain,
  3. Michael Feneley
  1. Department of Cardiology, St Vincent’s Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Dr Thomas Meredith, tom.meredith{at}gmail.com

Summary

The timely diagnosis of aortic dissection is notoriously confounded by unreliable symptomatology. We present a previously unreported clinical sign: thoracic pain reproduced by abdominal palpation. Our case illustrates the dependence of traditional clinical features on the anatomical location of an aortic dissection and lends weight to the concept of aortic pain as being a dynamic product of inter-related changes in intraluminal pressure, volume, wall stress and diameter. The clinical sign we describe may be very specific of acute aortic pathology.

  • cardiovascular medicine
  • radiology (diagnostics)
  • cardiothoracic surgery

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2017-221653

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    Footnotes

    • Contributors All authors have contributed to the writing and editing of this case report. TM identified the case and initially examined the patient in the Emergency Department of our institution. TM did the literature review and construction of the case report. MF guided the areas for discussion. Further discussion points were added by PJ, who also made some grammatical and syntax adjustments. MF edited the final draft.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.