What is the diagnosis?BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2394 (Published 29 April 2016) Cite this as: BMJ 2016;353:i2394
- Mathew Tate, core trainee year 2 in cardiology and general internal medicine1,
- Simon Dubrey, consultant cardiologist1
- 1Department of Cardiology, Hillingdon Hospital, Uxbridge, UK
- Correspondence to: S Dubrey
A 55 year old man had chest and abdominal discomfort after a long haul flight. The chest discomfort resembled his usually stable angina pectoris. On admission his heart rate was 90 beats/min and his blood pressure was 95/52 mm Hg. Electrocardiography showed T wave inversion in the inferolateral leads, compatible with ischaemia, although serum troponin and D-dimer tests were negative. His arterial blood gases, pH, and lactate were normal. What does the supine abdominal radiograph show and what sign suggests the diagnosis (fig 1⇓)?
The radiograph shows numerous round …