This is the twelfth and final case in a series we are publishing that make up “The Nightmares Course” – a Sim Bootcamp for new residents. It is 3:00 am, you are called to the floor to assess a 73-year old man experiencing confusion, shortness of breath, and chest heaviness.
Tag: hypertension
Cocaine-induced Aortic Dissection
This 49-year old male had abdominal and chest pain that start while smoking cocaine. This is on top of a history of untreated hypertension. On exam, he has signs of aortic dissection and requires stabilization before going to the CT scanner. Upon arrival back from the CT scan (which confirms the diagnosis of Type A aortic dissection) the patient is altered and in shock. Assessment reveals the patient to be in cardiac tamponade requiring emergent pericardiocentesis.
Aortic Dissection
A 66-year-old female with a history of smoking, HTN and T2DM presents with syncope while walking her dog. She complains of retrosternal chest pain radiating to her jaw. She will become increasingly bradycardic and hypotensive, requiring the team to mobilize resources in order to facilitate diagnosis and management of an aortic dissection.
EM Sim Cases 