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Old 10-28-2011
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Question Marfan syndrome with tearing chest pain

36-year-old male patient, who has a history of Marfan's syndrome, presents with sudden onset of severe central tearing chest pain radiating to his back. The pain is 9/10 in severity and has no relation with exertion. He is a non-smoker and non-alcoholic. Measurement of his BP shows a difference of 35 mmHg between his two arms. Chest auscultation shows the presence of mid-systolic click and there is no murmur. What is the next most appropriate diagnostic step in the management of this patient?

A. Transesophageal echocardiography
B. MRI of the chest
C. Cardiac enzymes
D. Coronary angiogram
E. Ventilation-perfusion scan
F. Arterial blood gas analysis
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Old 10-28-2011
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a.transesophageal echo( aortic dissection)
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Old 10-28-2011
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A...TEE.....

Akua
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A:Transesophageal echocardiography
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transeso eCHO
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yes the answer is A. TEE
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TEE is rapid and highly specific for the diagnosis of aortic dissection
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Cardiology-, Internal-Medicine-, Step-2-Questions, Syndromes-Acronyms

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