A Case of Burning Throat Pain

Throat pain is a common complaint in the emergency department. The related diagnoses are varied, from simple gastroesophageal reflux disease to catastrophic aortic dissection. This case highlights the importance of pertinent patient history and frequent reassessments in order to recognize the latter.

A 58-year-old woman was found to have a type A aortic dissection after initially presenting to the emergency department with a chief complaint of "burning" throat pain. Throughout the patient's evaluation in the emergency department, her symptoms evolved from the complaint of mild throat pain and water brash to development of chest pain and sudden right lower extremity cramping. Her history of hypertension, smoking, and a previous cerebral aneurysm prompted further intervention, including aggressive blood pressure control and emergent imaging. A computed tomography scan with angiography revealed the diagnosis of a type A aortic dissection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We highlight the importance of recognizing that patient presentation may change throughout the course of the emergency department stay, and that our case represents an atypical presentation of serious disease.