unequal BP/pulses in the arms is a big key for aortic dissection
Why is is not pseudo aneurysm?
"Aortic pseudoaneurysms typically occur as a result of trauma +/- intervention, a considered subset of traumatic aortic injury in the majority of cases. They can be acute or chronic."
https://radiopaedia.org/articles/aortic-pseudoaneurysm?lang=us
just remember that cocaine is one of the common causes of aortic dissection in young people. there are other causes that are genetic such as marfan, but in this question its clearly mentions cocaine abuse. the pain of dissection radiates to the back and its sharp. widened mediastinum is also a key.
submitted by โneonem(629)
Major risk factor for aortic dissection is hypertension, and in this case might be due to cocaine use, which causes marked hypertension. Dissections cause a tear in the tunica intima -- blood can flow backwards into the pericardium and cause tamponade. This manifests as crackles in the lung due to poor left ventricular function (filling/diastolic problem due to compression).