Thoracic aortic dissection mistakenly diagnosed as pulmonary embolism: A potentially fatal error

Abstract

Thoracic aortic dissection may present in many different ways leading to delayed diagnosis, often with catastrophic results. We present a patient with sudden onset epigastric pain, breathlessness, fever and a left sided pleural effusion, who was initially treated for a chest infection, subsequently for pulmonary embolism, with a serendipitous diagnosis of aortic dissection eventually being made. The strength of association of pleural effusion and aortic dissection and the need for vigilance with regard to the diagnosis of aortic dissection is emphasised.