A 62-year-old man with a 40-pack-year smoking history presents with sudden-onset severe tearing back pain radiating to the anterior chest. Vital signs show BP 180/110 mmHg (right arm) and 140/95 mmHg (left arm), HR 102 bpm, RR 18, and SpO2 98% on room air. CXR demonstrates a widened mediastinum with left-sided pleural effusion. ECG shows normal ST segments. Which of the following is the most likely diagnosis?
- A)Pulmonary embolism
- B)Spontaneous pneumothorax
- C)Acute aortic dissectionGABARITO
- D)Aortic atherosclerosis
- E)Acute myocardial infarction
Explicação
Acute aortic dissection classically presents with sudden, severe tearing back pain, hypertension, and blood pressure differential between arms due to involvement of subclavian arteries. Widened mediastinum on CXR is characteristic. Ver explicação completa e trilha adaptativa →