This is Steve Carroll, and you're listening to the YAMBASA podcast. Today we're going to be doing a

screencast on aoric dissection. This disease is very tricky to diagnose, and it's easy to miss.

In fact, some would say that the standard of care is to miss this diagnosis on its first presentation.

So today we'll be going through all the basics of this, including the right questions to ask.

The history, physical, exam findings,

will also be talking about any imaging that you're going to have to do to diagnose this disease

properly and how to treat it and manage it. Now, today is the fourth anniversary of the EMBASA

podcast, so I just want to say thank you very much to everyone who has listened, supported,

and given comments

and feedback on the podcast as we've grown for these first four years. I will say that I plan

on continuing this for as long as I can, and I appreciate everyone who's helped, especially those

who have contributed episodes, both in the past and those who are pending publication. So thank you

very much. So as always, I have to say,

this podcast is represented with the Vizier Pins Department of Fence, the OS Army, the Shawshack, E.M.

Residency Program. So let's talk about a few cases to help put this disease into context. First of all,

you've got that 70-year-old male. He's got a sudden onset of tearing chest pain, but chest x-ray is normal. Can you exclude a aortic dissection

in this patient? Just keep that in the back of your mind for a second here. Your next patient

is a 40-year-old male with Stemi. How concerned do you have to be, how worried do you have to be

about aortic dissection in this patient? Next, you have an 82-year-old male who's got poorly

controlled hypertension and a confirmed type A dissection.

His blood pressure is 200 over 100, and you see that his baseline in the clinic is usually 180.

First of all, how do you treat this patient, and how low do you push his blood pressure?

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