A 45-year-old man presents with sudden, severe chest pain radiating to his back, and a decreased level of consciousness. His blood pressure is significantly lower in his right arm compared to his left. What are the possible causes and next steps?
This patient's symptoms are concerning for an aortic dissection, a potentially fatal condition where the inner layer of the aorta tears. The differing blood pressure measurements in his arms further support this. Immediate action includes stabilizing the patient's vital signs, administering pain control and initiating antihypertensive therapy. Urgent imaging, such as a CT angiogram, should be obtained to confirm the diagnosis.