An 80-Year-Old Man Is Brought to the Hospital Due to Increasing

question 222

Multiple Choice

An 80-year-old man is brought to the hospital due to increasing chest pain.  Over the past 6 weeks, he has had dry cough, dysphagia, and a change in voice quality.  The patient has a long history of hypertension.  He is an ex-smoker with a 35-pack-year history.  On physical examination, the patient appears anxious, pale, and diaphoretic.  Blood pressure is 80/60 mm Hg, pulse is 120/min, and respirations are 20/min.  While being evaluated in the emergency department, he develops cardiac arrest with pulseless electrical activity and cannot be resuscitated.  Autopsy is most likely to show which of the following findings?

• A)Fat globules in the pulmonary vasculature
• B)Left ventricular free-wall rupture
• C)Longitudinal tear in the esophagus
• D)Ruptured pulmonary bleb
• E)Ruptured thoracic aortic aneurysm

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