A 58-Year-Old Man Comes to the Emergency Department with Abrupt-Onset

A 58-year-old man comes to the emergency department with abrupt-onset, severe chest pain that radiates to his back.  His blood pressure is 220/130 mm Hg in the left arm and 180/100 mm Hg in the right.  His heart rate is 100/min.  Initial laboratory studies show normal serum troponin levels.  Electrocardiogram is negative for ST-segment changes.  This patient's acute condition was most likely triggered by which of the following events?

A) Intimal fatty streak formation
B) Intimal tearing
C) Medial calcification
D) Medial inflammation
E) Vasa vasorum obliteration

Correct Answer:

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