A 45-year-old man with Marfan syndrome presents with acute, tearing chest pain radiating to the back. Vital signs show BP 180/110 mmHg (right arm) and 140/95 mmHg (left arm), HR 102/min, RR 20/min, and SpO2 98% on room air. Physical examination reveals a new high-pitched diastolic murmur at the left sternal border. Chest X-ray shows widened mediastinum. He denies dyspnea. Which diagnosis best explains these findings?
- A)Pulmonary embolism
- B)Spontaneous pneumothorax
- C)Hypertensive emergency
- D)Acute myocardial infarction
- E)Aortic dissection (Type A)GABARITO
Explicação
Type A aortic dissection in Marfan syndrome presents with sudden severe chest/back pain, new aortic regurgitation (from proximal dissection affecting the aortic root), and blood pressure differentials between arms due to involvement of branch vessels. Marfan's... Ver explicação completa e trilha adaptativa →