A 58-Year-Old Man Comes to the Emergency Department with Abrupt-Onset

question 88

Multiple Choice

A 58-year-old man comes to the emergency department with abrupt-onset, severe chest pain that radiates to his back.  His blood pressure is 220/130 mm Hg in the left arm and 180/100 mm Hg in the right.  His heart rate is 100/min.  Initial laboratory studies show normal serum troponin levels.  Electrocardiogram is negative for ST-segment changes.  This patient's acute condition was most likely triggered by which of the following events?

• A)Intimal fatty streak formation
• B)Intimal tearing
• C)Medial calcification
• D)Medial inflammation
• E)Vasa vasorum obliteration

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