8th September 2020

A tall 37-year-old man presents with sudden onset tearing chest pain that radiates to the back

A tall 37-year-old man presents with sudden onset tearing chest pain that radiates to the back. He appears sweaty and clammy. Chest auscultation reveals a diastolic murmur. He has recently been under ophthalmic investigation for lens subluxation. His basic observations show that he is hypertensive (185/100 mmHg) with a blood pressure discrepancy between his two arms; his right arm is 155/85 mmHg. Distal pulse palpation reveals an absent left foot pulse and a faint right foot pulse. Chest inspection reveals anterior thoracic wall deformity and a chest X-ray shows mild scoliosis. You suspect aortic dissection.

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.