A 58-year-old man with long-standing uncontrolled hypertension presents with abrupt onset of severe tearing chest pain radiating to the back. Vital signs show BP 185/110 mmHg (right arm) and 160/95 mmHg (left arm), HR 102 bpm, RR 18, SpO2 98% on room air. Chest X-ray reveals a widened mediastinum. He denies dyspnea. He takes no antihypertensive medications. Which of the following is the most likely diagnosis?
- A)Peripheral arterial disease
- B)Syphilitic thoracic aortic aneurysm
- C)Aortic dissectionGABARITO
- D)Thromboangiitis obliterans
- E)Abdominal aortic aneurysm
Explicação
Aortic dissection is correct. Sudden tearing chest pain radiating to the back with pulse or blood pressure differentials strongly suggests an intimal tear with blood dissecting through the media. Chronic hypertension is the major risk factor in older adults. Ver explicação completa e trilha adaptativa →