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Aortic dissection — ABEM Board MCQ

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HardCardiovascular emergenciesAortic dissectionABEM Board

A 64-year-old man arrives with abrupt tearing chest pain radiating to the back. Triage acuity is ESI 2; BP is 192/104 mm Hg in the right arm and 164/92 mm Hg in the left, HR 104/min. He has a new diastolic murmur and unequal radial pulses. ECG shows no ST elevation, and creatinine is normal. Which of the following is the most appropriate imaging study?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — CT angiography of the chest, abdomen, and pelvis

CTA is the preferred rapid imaging test for suspected acute aortic syndrome in a stable patient with classic high-risk features.

Reference: ACEP Thoracic Aortic Dissection clinical policy