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MMLU / A 47-year-old man is brought to the emergency department 2 hours after the…

Problem

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question

A 47-year-old man is brought to the emergency department 2 hours after the sudden onset of shortness of breath, severe chest pain, and sweating. He has no history of similar symptoms. He has hypertension treated with hydrochlorothiazide. He has smoked one pack of cigarettes daily for 30 years. His pulse is 110/min, respirations are 24/min, and blood pressure is 110/50 mm Hg. A grade 3/6, diastolic blowing murmur is heard over the left sternal border and radiates to the right sternal border. Femoral pulses are decreased bilaterally. An ECG shows left ventricular hypertrophy. Which of the following is the most likely diagnosis?

choices

  1. Acute myocardial infarction
  2. Aortic dissection
  3. Esophageal rupture
  4. Mitral valve prolapse

subject

professional_medicine

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