Thread: Case 3

A 30-year-old African-American male with longstanding essential hypertension collapses after the sudden onset of severe chest pain. On physical examination, his radial pulses are weak but femoral pulses are normal. A chest radiograph reveals widening of the mediastinum. What is the pathology??

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(E) His symptoms suggest aortic dissection. Fragmentation of elastic fibers in the media of the aorta greatly weakens the wall of the aorta and predisposes to aortic dissection. Such cystic medial necrosis can occur in patients with long-standing hypertension or in those with Marfan syndrome.
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Dissecting aorta!!