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Acute aortic dissection — RCPSC EM MCQ

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HardCardiovascular emergenciesAcute aortic dissectionRCPSC EM

CTAS 1. A 71-year-old with Marfan habitus has abrupt tearing chest pain radiating to the back. BP is 198/104 in the right arm and 160/88 in the left, with a new diastolic murmur. ECG has nonspecific ST changes and troponin is mildly elevated. Creatinine is 86 µmol/L. What is the most appropriate investigation?

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

The presentation suggests acute aortic dissection; CT angiography is the usual rapid diagnostic test in a stable patient with acceptable renal function.

Reference: Canadian Cardiovascular Society aortic disease resources; Tintinalli's Emergency Medicine