Which finding is most consistent with a suspected aortic dissection?

• A. Chest pain with stable blood pressure
• B. Severe tearing pain radiating to the back with unequal blood pressures
• C. Dull back pain with equal blood pressure
• D. Headache with normal blood pressure

Answer: (B)

Aortic dissection tends to present with abrupt, severe chest pain that’s often described as tearing or ripping and may radiate to the back. A key clue is unequal blood pressures between the arms, reflecting the dissection’s impact on arterial flow to one side. This combination—severe tearing pain plus different arm BPs—points to a dissection much more than other conditions that might cause chest or back pain with normal or equal BP. The other options don’t fit this pattern: stable BP with chest pain is less typical for a dissection and could suggest other cardiac or pulmonary issues; dull back pain with equal BP is nonspecific; a headache with normal BP isn’t characteristic of aortic dissection.