*4.2.4 Cardiac murmurs*

*Differential Diagnosis of Chest Pain*

**3.10 Fluoroquinolone usage**

**4.1 Symptoms**

*4.1.1 Chest pain*

aorta is usually involved.

stroke, heart failure, and syncope.

hemothorax ,or hemoperitoneum.

*4.2.3 Transient pulse deficits*

the mesenteric artery.

rhage occurs.

*4.1.2 Syncope*

**4.2 Signs**

*4.2.1 Hypertension*

*4.2.2 Hypotension*

abdominal aorta.

tions and mortality.

aneurysm with fluoroquinolone usage [14].

**4. Clinical features of aortic dissection**

tion and compression of adjacent vascular structures.

Some observational studies relate an increased association of aortic dissection or

The signs and symptoms of aortic dissection depends upon the extent of dissec-

The most common symptom is severe pain of sudden onset, described by patient as sharp stabbing or tearing type. When pain localized to anterior chest wall, neck, or jaw, the point of origin of the aortic dissection is from the ascending aorta, and when it is localized to the interscapular area, abdomen, and back, the descending

Pain that is localized to the abdomen must raise the possibility of involvement of

In few cases the patient may present with pleuritic pain if pericardial hemor-

Dissection may present rarely without pain only and mostly in older patients in cases that involve the ascending aorta. Such patients also have more instances of

Usually happens in aortic dissection presenting with cardiac tamponade or

Seen with ascending aortic dissection and may be due to aortic rupture leading to carotid tamponade (more in females), acute aortic regurgitation, acute MI,

This results from the intimal flap or hematoma blocking or compressing the artery. It is common in dissection involving the aortic arch and thoracic and

Patients who presented with pulse deficits had more chances of having hypotension, coma, or neurological deficits. Such patients also had higher rates of complica-

brachiocephalic vessel involvement and occurs in up to 10% of patients.

Seen in 30% of type A and 70% of type B disease.

**68**

Aortic dissection involving the aortic valve results in aortic regurgitation and an early diastolic murmur in the Erb's point (Austin Flint murmur). It occurs in about 50–75% of all ascending aortic dissections.
