An 80-Year-Old Man Is Brought to the Hospital Due to Increasing

An 80-year-old man is brought to the hospital due to increasing chest pain.  Over the past 6 weeks, he has had dry cough, dysphagia, and a change in voice quality.  The patient has a long history of hypertension.  He is an ex-smoker with a 35-pack-year history.  On physical examination, the patient appears anxious, pale, and diaphoretic.  Blood pressure is 80/60 mm Hg, pulse is 120/min, and respirations are 20/min.  While being evaluated in the emergency department, he develops cardiac arrest with pulseless electrical activity and cannot be resuscitated.  Autopsy is most likely to show which of the following findings?

A) Fat globules in the pulmonary vasculature
B) Left ventricular free-wall rupture
C) Longitudinal tear in the esophagus
D) Ruptured pulmonary bleb
E) Ruptured thoracic aortic aneurysm

Correct Answer:

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