A 62-year-old man with tearing interscapular pain and hypertension
A branching clinical case simulation for a patient presenting with tearing interscapular pain. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 5hard20 min6 stages
- Patient
- 62 years, male
- Presenting complaint
- Tearing interscapular pain
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
A 62-year-old man presents to the emergency department with sudden-onset, severe tearing pain in the chest radiating to the interscapular region. He is hypertensive and in distress. You are the resident on duty. The patient looks pale and is clutching his chest. He reports no previous similar episodes. You need to act quickly.
What this case teaches
Suspect aortic dissection from history; avoid thrombolysis and anticoagulation; control heart rate and blood pressure with intravenous beta-blockade; arrange CT aortography and surgical referral.
How the case unfolds
- 1Initial Assessment and HistoryHistory
- 2Focused Physical ExaminationExamination
- 3Investigations and ImagingInvestigations
- 4Interpreting Findings and Formulating DiagnosisDiagnosis
- 5Immediate Medical ManagementTreatment
- 6Monitoring and Further careMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.