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July 2012, Volume 42 Number 7 , p 72 - 72


  • Dorothy S. Carlson DEd, RN
  • Ellen Pfadt MSN, RN


MR. C, 55, ARRIVES in the ED by ambulance accompanied by his wife. She states he developed an abrupt onset of "sharp, tearing" chest pain 20 minutes earlier while watching TV. He told his wife he felt like he was "going to pass out" and rated the pain intensity as 10/0-10.Upon arrival to the ED, Mr. C's vital signs are: apical pulse, 110, sinus tachycardia; respirations, 12; BP, 174/94 right arm, 150/70 left arm; SpO2, 92% on supplemental oxygen at 4 L/min via nasal cannula. He's pale and diaphoretic, but in no respiratory distress. Mr. C's wife states he's had hypertension for about 15 years but stopped taking his medication about 3 years ago.Based on Mr. C's history and physical assessment findings, you suspect an acute dissection involving the ascending aorta, a life-threatening, surgical emergency. Dissection involves a tear in the aortic intima, creating a false lumen and allowing blood to collect between the intima and media. The most common risk factors for acute aortic dissection

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