NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationHard
A 60-year-old male with a history of hypertension and hyperlipidemia presents with sudden, sharp, tearing pain in his back, radiating to his abdomen. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. His radial pulses are weak and unequal. What condition should the EMT MOST suspect?
- AAortic dissection.
- BPulmonary embolism.
- CAcute myocardial infarction.
- DCongestive heart failure.
Show answer & explanationAnswer & explanation
Correct answer: A. Aortic dissection.
The sudden, sharp, tearing back pain, unequal blood pressures between arms, and unequal/weak pulses are classic signs and symptoms of an aortic dissection, a life-threatening emergency. His history of hypertension is a significant risk factor.
Why the other options are wrong
- B. Pulmonary embolism typically presents with sudden dyspnea, pleuritic chest pain, and sometimes hemoptysis, not tearing back pain and unequal pulses.
- C. While chest pain can radiate, the tearing quality, back pain, and unequal pulses are not typical for AMI.
- D. Congestive heart failure primarily involves respiratory distress, crackles, and edema, not acute tearing back pain and unequal pulses.
Aortic Dissection Recognition
Identification of a life-threatening condition where the inner layer of the aorta tears, allowing blood to flow between the layers, causing severe pain and potential organ damage.
- Sudden, severe, 'tearing' or 'ripping' pain in chest or back.
- Pain often radiates to back, abdomen, or neck.
- Blood pressure differences between arms (>20 mmHg difference is significant).
- Pulse deficits or unequal pulses.
- Neurological deficits or signs of organ ischemia may occur.
Memory trick: Tearing pain, BP's not the same, Aorta's torn, a dangerous game.