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Acute aortic dissection — ABEM Board MCQ

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HardCardiovascular emergenciesAcute aortic dissectionABEM Board

A 61-year-old man presents as triage level 2 with tearing chest pain radiating to the back. BP is 206/104 mm Hg in the right arm and 168/90 mm Hg in the left. ECG shows no ST elevation; creatinine is 1.0 mg/dL and chest radiograph shows mediastinal widening. 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: E — CT angiography of the chest, abdomen, and pelvis

Suspected acute aortic dissection in a stable patient is best evaluated with contrast CT angiography covering the thoracic and abdominal aorta.

Reference: ACEP Clinical Policy: Thoracic Aortic Dissection; ABEM EM Model