Match the following classic clinical presentations with the most likely cardiothoracic or vascular surgical diagnosis.
- A 65-year-old man with hypertension presents with sudden, severe, 'tearing' chest pain that radiates to his back.Acute aortic dissection
- A 70-year-old man with a smoking history presents with a palpable, asymptomatic, pulsatile mass just above the umbilicus.Abdominal aortic aneurysm
- A 68-year-old woman with atrial fibrillation develops sudden onset of a pale, cold, pulseless, and painful right leg.Acute limb ischemia
- A 60-year-old diabetic man reports right calf cramping that occurs consistently after walking two blocks and resolves after brief rest.Intermittent claudication
Answer
The correct pairings link tearing chest/back pain with acute aortic dissection, a pulsatile abdominal mass with abdominal aortic aneurysm, a sudden pale/pulseless limb with acute limb ischemia, and exertional calf pain relieved by rest with intermittent claudication.
Each correct pair represents the quintessential presentation of a major vascular condition. Aortic dissection classically presents with sudden tearing back pain. Abdominal aortic aneurysms typically present as an asymptomatic pulsatile mass. Acute limb ischemia presents suddenly with the 6 Ps (often secondary to an embolus from atrial fibrillation). Intermittent claudication presents with reproducible exertional pain due to chronic peripheral arterial disease.
Step-by-Step Solution
Key Concept
Classic clinical presentations of major cardiothoracic and vascular surgical conditions