一位 55 歲高血壓病史個案，自述突發撕裂樣胸痛並放射至背部。下列何項評估發現需立即處理？
A 55-year-old client with a history of hypertension reports a sudden, severe "tearing" chest pain radiating to the back. Which assessment finding requires immediate intervention?
- AHeart rate of 110 beats per minute心率每分鐘 110 次
- BPulse pressure of 30 mmHg脈壓差 30 mmHg
- CBlood pressure discrepancy of 20 mmHg between the arms✓ 正解雙臂血壓差異達 20 mmHg
- DBlood pressure of 180/100 mmHg in both arms雙臂血壓均為 180/100 mmHg
主動脈剝離（Aortic Dissection）是一種致命性的血管急症，典型症狀為突發、撕裂樣胸痛並放射至背部。當出現雙側手臂血壓差異（>20 mmHg）時，顯示剝離已經影響到主動脈分支血管，導致血流分配不均，這是極為緊急的生命徵象異常，必須立刻通知醫師並進行降壓與減緩心率的治療，以防止主動脈破裂。
Aortic dissection is a life-threatening vascular emergency, classically presenting with sudden, tearing chest pain radiating to the back. The presence of a blood pressure difference between the arms (>20 mmHg) indicates that the dissection has involved branch vessels of the aorta, leading to unequal blood flow distribution—an extremely urgent abnormal sign that requires immediate notification of the physician and initiation of treatment to lower blood pressure and heart rate in order to prevent aortic rupture.