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Questions
Findings

What is the main diagnosis you want to confirm?

With sudden onset pain, and distal (leg) changes, there is a high index of suspicion for an aortic dissection.

How would you best investigate this?

CT angiogram from arch to bifurcation is typically performed at our centre for aortic dissection. This is preceded by a non-contrast chest to evaluate for intimal haematoma, and then is an ECG-gated arterial phase study.

Presentation

Sudden onset chest and epigastric pain. Associated leg numbness, no weakness. Background type 2 diabetes, hypertension. Normal ECG.

Patient Data

Age:	80 years
Gender:	Female