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Aortic dissection gets put under the ACEP microscope.
I think Rob Rogers who presented a most excellent Aortic Dissection lecture a while back gave the Pearl..."Chest Pain and something else" ie CP with flank pain, limb pain or paraesthesia, lower abd pain etc which I found golden. When someone dissects they very often do have CP "and something else" due to the anatomy of the dz. So while we rightfully think ACS, PE, CHF, Pulmonary issues primarily w a CP pt, when u get that pt that seems to have CP and some other seemingly unrelated "second CC" ones sphincter should crank down a bit.
What you do matters.