A 50-year-old male with a history of untreated hypertension comes to the clinic complaining of chest pain that is radiating to his back. The pain started suddenly and is described as "tearing". What is the likely diagnosis and immediate management?
The patient's chest pain, described as "tearing" and radiating to his back, is suggestive of aortic dissection, a life-threatening condition often related to uncontrolled hypertension. Immediate management includes pain control and blood pressure reduction, typically with intravenous beta-blockers like labetalol or esmolol. An urgent CT angiogram of the chest would be the next step to confirm the diagnosis.