BCEN CEN Practice Question

The sudden onset of maximal, tearing chest pain radiating to the back, particularly when accompanied by hypertension and a pulse or blood-pressure discrepancy between the upper extremities, is classic for acute aortic dissection. Pericarditis causes sharp, pleuritic pain that improves when the patient leans forward and is not associated with pulse deficits. Pulmonary embolism typically presents with pleuritic chest pain and dyspnea rather than tearing interscapular pain or asymmetric pulses. Tension pneumothorax produces unilateral decreased breath sounds, tracheal deviation, and severe respiratory distress, not the findings described.