A 66year-old male presents to the local ER at 6 AM. The patient reports that hehas been having severe chest pain since last night before he wentto bed. The patient says that he just simply thought that he washaving a “bad case of indigestion and gas” after eatinga bunch of fatty foods while watching the football with his friendslast night. He says he took Pepto Bismolto help ease the pain. The patient says that he woke up around 3 AMthis morning with increased upper and mid abdominal pain. Hedescribed the pain as “sharp and gnawing” right underneath his ribcage. The patient was immediately brought back to a room fromtriage. The ER staff was about to do a shift change and so theovernight physician medically screened the patient and ordered astandard set of lab tests. The patient was given a 325 mg aspirintablet after getting undressed and laying down on the bed.After approximately 15 min after arrival to his room, the patientstarted writhing in the bed complaining of increased abdominal pain. Thepatient reported his pain level of 20 on a scale of 1 to 10.The patient’s history is significant for noncompliant hypertension,hypercholesterolemia, moderate obesity, and smoking 1.5pk/d, buthad stopped five years ago.

Upon physical examination, the patient was diaphoretic, and hadpallor. Strong pulsations were found with light palpation over the middleof the abdomen. With deeperpalpation, aortic bruits were detected by auscultation. There was radiation of the pain to the lumber area of theback. The morning physician ordered a series of diagnostic imagingstudies to determine if there were any issuescontributingto the patient’s pain within the abdomen. After the imaging studies were completed. Theradiologist called the physician on duty and said that patientneeded immediate surgery. One of the imaging studiesdone showed there was a 5.4 cm diameter measurement of the aorta. Arrangement were immediately made to flythe patient to a trauma center for surgery.

1. What condition does this patient have?

2. What are the diagnostic testing that the morning physicianordered?

3. What are the risk factors that contributed to the patient’scondition?

4. What is the proper protocol for treatment of the patient’scondition? How is it done?

5. What would happen if the patient did not receive the appropriatetreatment in time?