A 65-Year-Old Man Presented to the Emergency Department Complaining of Severe

A 65-year-old man presented to the emergency department complaining of severe tearing chest pain radiating to the back, unrelieved by analgesics. It started a few hours ago, with nausea, vomiting, and excessive sweating. The patient is a known case of essential hypertension since he was 25 years old. He is not compliant with his drugs. He has COPD with 35-pack-year smoking history. He has chronic kidney disease. On examination, BP 200/100, Heart rate 120 pulse/min, O₂ sat 98%. ECG showed signs of left ventricular hypertrophy, with no ischemic changes. He has normal chest expansion bilaterally, with normal tactile fremitus and normal breath sounds. Transesophageal echocardigram was done and aortic dissection involving ascedning and descending aorta was detected . What is the origin of the intimal flap?

A) Renal Arteries
B) Near the left subclavian artery
C) Thyrocervical Trunk
D) Brachicephalic Artery

Correct Answer:

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