The patient
A 76 year old hypertensive woman presented with massive haemoptysis and right-sided pleuritic chest
pain.
Investigations
A chest radiograph and computed tomography (CT) were performed.
Comment
In the majority of cases of thoracic aortic dissection, the predominant presenting symptom is chest pain,
occurring in over 90% ofcases. Haemoptysis is a rare but well-documented complication, occurring in 6%
of cases.' It may rarely be the sole presenting feature2 and may occur in association with a mediastinal
haematoma
