- Pain is “sharp,” “tearing” or “ripping,” as opposed to the dull, heavy ache of coronary disease.
- May radiate to the back or anywhere, or remain in the chest.
- Marfan’s syndrome
- Congenital bicuspid aortic valves.
- Wide mediastinum or tracheal deviation
- Normal up to 1/3 of the time.
Bottom line: sudden onset of severe sharp or tearing chest pain in a patient at risk warrants CT in the ED.
See posting Chest Pain – 3.