The Question is from neet-botany biotechnology , and it was created by the author K SURESH KUMAR

Question

A 60-year-old male with a history of hypertension and diabetes presents with sudden onset of severe tearing chest pain radiating to the back.  Which of the following diagnostic tests is MOST likely to confirm the diagnosis?

K SURESH KUMAR · Accepted Answer

## CORE INFORMATION
✓ **Answer**: C
## CONCEPT FRAMEWORK
 **Primary Concept**: Diagnosing Aortic Dissection
 **Related Topics**: Chest pain, cardiovascular emergencies, diagnostic imaging
 **Prerequisites**: Understanding of aortic dissection presentation and diagnostic modalities.
## SOLUTION PATHWAY
**Given Information**:
  60-year-old male
  History of hypertension and diabetes
  Sudden onset of severe tearing chest pain radiating to the back
  Important conditions:  The symptoms strongly suggest an aortic dissection.
**Method & Steps**:
 1. Consider the differential diagnosis. The presentation points towards an acute aortic dissection, a life-threatening condition.
  Reasoning:  Tearing chest pain radiating to the back is a classic symptom of aortic dissection. Hypertension and diabetes are risk factors.
  Formula/Rule: No specific formula applies, but clinical reasoning and knowledge of symptoms are crucial.
 2. Evaluate the diagnostic options.
  Working:  
            * Chest X-ray: May show widening of the mediastinum, but it's not definitive for aortic dissection.
            * ECG: Can rule out myocardial infarction, but not specific to aortic dissection.
            * CT angiography of the chest: Provides detailed visualization of the aorta, allowing for direct visualization and confirmation of an aortic dissection. This is the gold standard for diagnosis.
            * Cardiac MRI: Can also visualize the aorta, but CT angiography is faster and more readily available in emergency situations.
  Key Point: Speed is crucial in diagnosing and managing aortic dissection, hence the preference for CT angiography.
 3. Select the most appropriate test.
  Result: CT angiography of the chest is the most likely test to confirm the diagnosis of aortic dissection.
  Verification: CT angiography directly visualizes the aorta and can show the characteristic features of an aortic dissection (e.g., intimal flap, false lumen).
 ## OPTION ANALYSIS
A :x: Chest X-ray is not specific enough and may show non-specific findings.
B :x: ECG is useful for ruling out myocardial infarction but not for diagnosing aortic dissection.
C ✓: CT angiography is the gold standard for diagnosing aortic dissection.
D :x: Cardiac MRI can visualize the aorta, but CT angiography is faster and more readily available in emergency situations.
 ## LEARNING AIDS
 **Common Mistakes**:
  1.Choosing a less sensitive or specific test:  Relying on a chest x-ray or ECG alone could lead to a delay in diagnosis and treatment.
  2. Overlooking the clinical presentation: Failing to recognize the classic symptoms of tearing chest pain radiating to the back.
 **Quick Tips**:
  1. Think of the classic presentation of aortic dissection when encountering severe tearing chest pain radiating to the back.
  2. Remember CT angiography is the gold standard for diagnosis.

K SURESH KUMAR · Answer

Chest X-ray

K SURESH KUMAR · Answer

ECG

K SURESH KUMAR · Answer

The correct Option is "CT angiography of the chest"

K SURESH KUMAR · Answer

Cardiac MRI

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