The Rational Clinical Examination
David L. Simel, Drummond Rennie
Thoracic Aortic Dissection
aorta thoracic ascending dissection, chest pain, acute, dissection of aorta, focal neurologic deficits
"A 64-year-old man with a history of hypertension presents to
the emergency department after sudden onset of severe, anterior
chest pain. On examination, he is alert but uncomfortable. His blood
pressure is normal and identical in both arms. His chest is clear,
and careful cardiac auscultation fails to reveal a diastolic murmur.
A chest radiograph reveals a small pleural effusion but is otherwise unremarkable...."
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