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Acute aortic dissection — ABEM Board MCQ

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HardCardiovascular emergenciesAcute aortic dissectionABEM Board

A 77-year-old woman arrives as ESI 2 with abrupt tearing chest pain radiating to the back. BP is 218/112 in the right arm and 184/96 in the left; HR 118. Chest x-ray shows widened mediastinum 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: B — CT angiography of the chest, abdomen, and pelvis

CTA is the usual rapid diagnostic test for suspected acute aortic syndrome in a stable patient with normal renal function.

Reference: ACEP Clinical Policy: Thoracic Aortic Dissection; AHA aortic disease guideline