A 53 year-old male with history of asthma, methamphetamine and cocaine use, and ventral hernia, presents with chief complaint of sudden onset chest pain that occurred this morning. Patient endorses a severe constant sharp pain with associated shortness of breath and nausea that woke him from sleep. He took an aspirin just prior to arrival with no relief. On exam the patient is diaphoretic. Recent blood work obtained for upcoming hernia repair shows normal renal function.
A CXR and CTA chest are obtained and show the following:
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Can you guess the diagnosis?
Leave a comment below and tell us how you would manage this patient.
The actual diagnosis for this real-life case will be posted in 1 week.
Three's company...
ReplyDeleteAorta is dissecting? All the way to the l. ventricle?
ReplyDeletelooks like a debakey type 1 dissection (ascending and descending aorta).
ReplyDeletethats a problem…get that HR and BP down, type and cross for a million (ok probably just 14) units and call a CT/Vascular surgeon STAT!
ReplyDelete