A 74-year-old woman is brought to hospital because of a 5-day history of worsening chest pain. She has shortness of breath, difficulty swallowing, hoarseness of voice, and stridor. She has hypertension currently managed with hydrochlorothiazide. She has smoked 1.5 packs of cigarettes per day for 40 years. Her vitals are: temperature 98.6F, HR 82, RR 14, BP 164/96. Physical examination shows a pulsation superior to the manubrium with slight tracheal deviation to the left. Chest auscultation suggests clear lung fields bilaterally. There is a 2/6 diastolic flow murmur down the right sternal border. Which of the following is the most likely diagnosis?
Aortic aneurysm
Aortic stenosis
Decompensated coarctation of the aorta
Pneumothorax
Pulmonary regurgitation
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Cut-to-the-chase Answer (0:37):
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HY USMLE Answer (8:41):
