Author: Eduard Deda / Editor: Nick Tilbury / Codes: NeuP2, ResP1, SLO1 / Published: 24/02/2022
A 57-year-old gentleman self-presents to the Emergency Department (ED) with a 1-hour history of a posterior headache and chest pain.
The headache started suddenly while he was sitting down at his desk, and he says it came on like a “slap to the back of the head”. He rates it as 5/10 in severity.
He also tells you he developed central chest pain around the same time as the headache and describes it as a tightness across his chest. It is non-radiating, there are no exacerbating factors and there is no relief from simple analgesia.
The patient has known hypercholesterolaemia and hypertension, for which he takes medication, but nil else of note. He has no allergies.
His observations are as follows:
- Blood pressure – 147/89mmHg
- Heart rate – 87
- SpO2 – 98% on room air
- Apyrexial
Full neurological and cardiovascular examination is unremarkable, apart from a difference in timing of the pulses of the left and right posterior tibialis.
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Question 1 of 3
1. Question
Which of the following are known risk factors for aortic dissection? (Select all may that apply)
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Question 2 of 3
2. Question
The following ECG is performed by the time you review him again after analgesia in department. The pain remains the same as before.
What are the findings on the ECG?
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3. Question
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6 responses
Interested case
GOOD ONE
Useful
could not see a picture of the ECG but good learning all the same
useful
Useful module. I wonder what became of the patient