QuestionSBA
QuestionChoice
Aortic dissection is when a tear in the tunica intima of the aorta occurs thereby letting blood flow in between the inner and outer layers of the aorta walls. Risk factors include hypertension and a classical presentation is a man typically >50 years old with sudden onset chest pain that radiates to the back.
10000076
a
Aortic dissection
QuestionChoice
Chest pain in this case is often centralised and radiates down the left arm or up the jaw. It is classically a 'crushing' chest pain rather than 'tearing' as seen in aortic dissection.
10000080
e
Non-ST-elevated Myocardial Infarction
QuestionChoice
Atrial fibrillation is when there is uncoordinated atrial contraction. Patients would often have chest pain, palpitations, and dyspnoea and on examination, an irregularly irregular pulse would be felt.
10000078
c
Atrial fibrillation
QuestionChoice
Fluid or blood can accumulate in the pericardial space causing chest pain and dyspnoea. This is a medical emergency, however, as the chest pain, in this case, radiates to the back, it is more indicative of aortic dissection.
10000079
d
Cardiac tamponade
QuestionChoice
Marfan's syndrome is a connective tissue disorder and is a risk factor for aortic dissection, however, there are no features in this question which indicate Marfan's syndrome.
10000077
b
Marfan's syndrome
Concept
Chapter
2693
3707
Aortic Dissection
Topic
134
Cardiology
12562
A 57-year-old male presents to A&E with severe sudden onset chest pain that radiates to his back. He has a past medical history of hypertension and type 2 diabetes mellitus.

Which of the following is the most likely diagnosis?
a