— 生理適應 · MEDIUM · MCQ —
一位有高血壓病史的病人自訴突然出現嚴重的「撕裂樣」胸痛，並輻射至背部。護理師應懷疑哪種情況？
A client with a history of hypertension reports a sudden, severe "tearing" pain in the chest that radiates to the back. Which condition should the nurse suspect?
- AAortic Dissection✓ 正解主動脈剝離
- BPneumothorax氣胸
- CPulmonary Embolism肺栓塞
- DMyocardial Infarction (MI)心肌梗塞 (MI)
— Explanation · 中文詳解 —
「撕裂樣（Tearing/Ripping）」痛且輻射到背部是主動脈剝離（Aortic Dissection）的典型特徵。MI 通常是壓迫感（D）；肺栓塞多伴隨呼吸困難和肋膜痛（C）；氣胸則多為突發性單側刺痛（B）。高血壓是主動脈剝離的主要風險因子。
Sudden, severe "tearing" chest pain radiating to the back is the classic presentation of aortic dissection, especially in clients with hypertension. This distinguishes it from myocardial infarction (pressure/heaviness), pulmonary embolism (pleuritic pain/dyspnea), or pneumothorax (sharp unilateral pain).
✦ 台美臨床差異
無差異。此為急診鑑別診斷的重要臨床徵象。