A 40-year-old male with obesity presents with sudden onset of severe left-sided chest pain that radiates to his back. He also reports feeling lightheaded. His blood pressure is significantly higher on his right arm compared to his left. What are the potential diagnoses and next steps?
The patient's symptoms, particularly the sudden onset severe chest pain and difference in blood pressure between arms, could suggest an aortic dissection, a serious condition that requires immediate attention. Obesity is a risk factor due to the associated hypertension. Immediate steps include a CT angiogram or an MRI to confirm the diagnosis. If confirmed, the patient would require hospitalization and likely surgery.