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A 78-year-old man presents to the Emergency Department with sudden onset of left-sided chest pain radiating to his back. He has a past history of stable angina and peripheral vascular disease. His blood pressure is 80/50 mmHg with a heart rate of 120/minute. Which one of the following tests is most likely to confirm his diagnosis?
1. Electrocardiogram.
2. Chest radiograph.
3. Echocardiogram.
4. Ventilation-perfusion (V/Q) of the lung.
5. Computerized tomography (CT) of the chest.
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(widened mediastinum) on Cxr?
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I dont have correct answer.
I think it should be 1.
1 ---May be due to past history of IHD and PVD and Old age....May be its due to Inferior wall MI.
If the history of Truma then It would be 2...what do u say ??
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yeah I think youre right. I was thinking about it and you always gotta rule out MI with chest pain, so EKG sounds right...
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left-sided chest pain'' is usually not due 2 MI
radiating to his back- most suggestive of Dissection
He has a past history of stable angina and peripheral vascular disease.
His blood pressure is 80/50 mmHg with heart rate of 120/minute.- suggests bleed, n hypo
so its obviously a dissection ...
''which test is most likely to confirm'- its not asking 1st step
its asking how do u ''CONFIRM ''the Dissection...?
now wat do u say...
i say CT chest....
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CT in an hemodynamically unstable pt?
I'llgo with 3 ( TEE not given among choices)
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CT in hemodynamically unstable pt?
I'llgo with 3 ( TEE not given among choices)
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Q is about confirmation,,not initial so i chose CT
