Snapshot A 55-year-old man presents to the emergency department with chest pain. He describes the pain as excruciating and knife-like that began earlier in the morning. His pain is restricted to the anterior chest. Medical history is significant for hypertension, for which he is taking lisinopril. Physical examination is significant for unequal blood pressures in the arm and a diastolic murmur in the left sternal border. An electrocardiogram is unremarkable, his cardiac troponins are not elevated, and a chest radiograph demonstrates a widened mediastinum. Preparations are made to obtain a CT angiography. Introduction Clinical definition login to view 6 more bullets Etiology login to view 3 more bullets Pathogenesis login to view 2 more bullets Associated conditions login to view 2 more bullets Prognosis login to view 4 more bullets Presentation Symptoms login to view 2 more bullets Physical exam login to view 4 more bullets Imaging Radiography of the chest login to view 4 more bullets CT angiography of the chest login to view 2 more bullets Differential Myocardial infarction login to view 3 more bullets Treatment Medical login to view 3 more bullets Surgical login to view 3 more bullets Complications End-organ damage login to view 1 more bullet Aneurysm rupture