Published 12 November 2008, doi:10.1136/bmj.a1844
Cite this as: BMJ 2008;337:a1844

Endgames

Case report

Sudden onset of headache and recent breathlessness

Radhakrishnan Ramaraj, resident physician

1 Department of Internal Medicine, University of Arizona College of Medicine, Tucson, AZ 85724, USA

drkutty2@gmail.com

The first 150 words of the full text of this article appear below.

A 70 year old man presented with a 30 minute history of throbbing left sided headache that woke him from sleep. He had no history of headache or recent head injury. He also described a four day history of breathlessness when climbing one flight of stairs.

He was taking tablets for type 2 diabetes mellitus, hypertension, and congestive cardiac failure. He did not smoke and drank seven units of alcohol a week.

The patient was alert and oriented, with a heart rate of 100 beats/minute and a blood pressure of 150/90 mm Hg. Respiratory rate was 16 breaths per minute, oxygen saturation was 98% on air, and his lungs were clear to auscultation. An early diastolic murmur was heard at the base of the heart. He had no temporal artery tenderness or neck stiffness.

Haemoglobin was 13.2 g/l; white blood cell count was 7x109 cells/l; urea and electrolytes, . . . [Full text of this article]

Causes of aortic dissection
Common causes

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