Sudden in Medicine / Internal Medicine — 65yo Woman | Cardiology | SMLE Q#17901
SMLE Question #17901
Medicine / Internal Medicine
Cardiology
Objective: OBJ-IM-CARD-ADIS-01
Last updated: February 2026
A 65-year-old woman presents to the emergency department with sudden, severe epigastric pain radiating to her back that began 1 hour ago. The pain is constant. She has long-standing hypertension and has been nonadherent to medications. She is distressed and diaphoretic. Peripheral pulses are palpable and symmetric. A portable chest X-ray shows widening of the mediastinum. Which diagnosis best explains her presentation?
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