A 62-year-old man with poorly controlled hypertension presents with sudden-onset tearing chest pain radiating to the back. Vital signs show BP 180/110 mmHg (right arm) and 150/95 mmHg (left arm), HR 98/min, RR 18/min, temp 37.2°C. Chest radiograph demonstrates mediastinal widening. Troponin is normal. He denies dyspnea. Which of the following is the most likely diagnosis?
- A)Esophageal rupture
- B)Aortic dissectionGABARITO
- C)Acute myocardial infarction
- D)Stable angina
- E)Pulmonary embolism
Explicação
Aortic dissection presents with abrupt severe tearing pain radiating to the back and may cause pulse or blood pressure differentials between extremities. Long standing hypertension predisposes to intimal tear with blood dissecting through the media. Widened me... Ver explicação completa e trilha adaptativa →