skip to main content

Aortic dissection mimicking ACS — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

HardMedical EmergenciesAortic dissection mimicking ACSDipIMC

A 61-year-old man has sudden tearing chest pain radiating to the back after lifting furniture. Blood pressure is 206/110 in the right arm and 168/94 in the left, pulse 104/min, ECG shows no ST elevation and he has transient left leg weakness. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: D — Pre-alert for suspected aortic dissection and avoid antithrombotic loading

The abrupt tearing pain, inter-arm pressure difference and transient neurological deficit strongly suggest aortic dissection. Antiplatelet or thrombolytic treatment may be harmful if dissection is the cause. A non-diagnostic ECG does not make the presentation low risk.

Reference: JRCALC Guidelines; NICE acute aortic syndrome principles