In case you didn’t encounter a patient with sharp inter scapular pain today!
A 67-year-old male patient presented with sharp interscapular pain. BP: 189/107 mmHg, HR: 118 bpm, RR: 26/min, T: 37, SpO2: 93% in room air. He has a history of hypertension and diabetes mellitus. The chest x-ray is shown below.
Let’s remember findings of aortic dissection in the chest x-ray.
- Depression of the left mainstem bronchus
- Displaced intimal calcification
- Indistinct or irregular aortic contour
- Left apical pleural cap
- Opacification of the “AP window” (i.e., clear space between the aorta and the pulmonary artery)
- Pleural effusion (left > right)
- Tracheal or esophageal deviation
- Widened aortic knob or mediastinum (present in only 63% and 56% of patients with type A and type B dissections, respectively)