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Brunson JM et al. – A 79–year–old man with a known ascending aortic aneurysm presented to his physician's office with an episode of severe “tearing” type chest pain after lifting several boxes. Physical examination was notable for low blood pressure and a new diastolic murmur. The patient was transferred to intensive care, and a transthoracic echocardiogram was performed. This demonstrated a dissection flap clearly seen superior to the sinuses of Valsalva and severe aortic insufficiency.


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