Long-standing Hypertension To Emergency in Medicine / Internal Medicine — 62yo Woman | Cardiology | SMLE Q#17665
SMLE Question #17665
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
A 62-year-old woman with a history of long-standing hypertension presents to the emergency department with sudden-onset severe chest pain that radiates to her back. She describes the pain as tearing and constant. She is diaphoretic and anxious.
Vital signs:
- T: 36.8 °C
- BP: 198/110 mmHg (right arm), 170/96 mmHg (left arm)
- HR: 108 /min
- RR: 22 /min
- SpO2: 97% (RA)
A chest X-ray shows a widened mediastinum. Which diagnosis best explains this presentation?
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