Vascular Disease USMLE Step 1 Practice Question
A 62-year-old hypertensive man with a 40-pack-year smoking history presents with sudden-onset severe substernal chest pain radiating to the back. Vital signs show BP 168/95 mmHg, HR 102 bpm, RR 18/min, and normal oxygen saturation. Physical examination reveals a 20 mmHg systolic blood pressure differential between arms and no focal neurological deficits. CTA chest demonstrates a linear intimal flap within the descending thoracic aorta. Which of the following is the most likely diagnosis?
Answer choices
- AAcute myocardial infarction
- BTension pneumothorax
- CEsophageal rupture
- DAcute aortic dissectionCorrect answer
- EPulmonary embolism
- FThoracic aortic aneurysm with contained rupture
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