NDLI: Chest pain, dyspnoea and elevated D-dimer in a recent air traveller

Content Provider	PubMed Central
Author	Lima, Joaquim Santos Sandler, Belinda Mcwilliams, Eric
Copyright Year	2011
Abstract	A previously asymptomatic 69-year-old lady, who recently travelled on a 4 h flight, presented with acute left-sided pleuritic pain, dyspnoea and calf pain. Blood gases revealed hypoxaemia and D-dimer was significantly elevated. She also had low-grade fever, leukocytosis and a small left-sided pleural effusion on chest x-ray. The working diagnosis was pulmonary embolism and chest infection and she received low molecular weight heparin and antibiotics. A subsequent CT pulmonary angiogram ruled out pulmonary embolism but revealed an abnormal finding in the ascending aorta, suggestive of a penetrating aortic ulcer. Urgent transoesophageal echocardiography was consistent with an intramural haematoma and the patient underwent emergency aortic root replacement with imminent aortic rupture confirmed at surgery. This case highlights the fact that acute aortic syndromes may have atypical presentations and also emphasises the fact that D-dimer levels are elevated in aortic syndromes.
Related Links	http://dx.doi.org/10.1136/bcr.04.2011.4104
Starting Page	420114104
File Format	PDF
ISSN	1757790X
e-ISSN	1757790X
Journal	BMJ Case Reports
Volume Number	2011
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2011-08-17
Access Restriction	Open
Rights Holder	BMJ Publishing Group
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Medicine

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Chest pain, dyspnoea and elevated D-dimer in a recent air traveller