A 55-year-old male with a history of hypertension and hyperlipidemia presents with sudden onset of excruciating, tearing chest pain radiating to his back. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. A cardiac murmur is noted. Which of the following is the most appropriate initial diagnostic study?

The correct answer to the question "A 55-year-old male with a history of hypertension and hyperlipidemia presents with sudden onset of excruciating, tearing chest pain radiating to his back. His blood pressure is 180/100 mmHg in the right arm and 140/80 mmHg in the left arm. A cardiac murmur is noted. Which of the following is the most appropriate initial diagnostic study?" is Option C: CT angiography of the chest.

The other options — A) Electrocardiogram (ECG), B) Cardiac troponin I levels, D) Echocardiogram — are incorrect for this USMLE Exam Prep question. As explained above: The patient's presentation with tearing chest pain radiating to the back, pulse deficit, and blood pressure differential strongly suggests acute aortic dissection. CT angiography of the chest is the …