Elderly + Severe CCP + Weakness

Presentation
Elderly
BIBA CCP and syncopal episode
assoc new L side weakness 3/5 bilat to UL / LL.

In Setting Of:
PMHx: Longstanding CCF and HTN, PD.
Meds: Levodopa, pregabalin, perindopril, Catapress, Tacidine, Ezetimibe/simvastatin, Imigran, Aspirin, Quinate.
MAS notes: Required high amount of opiate analgesia for pain control.

O/E:
L arm sBP 149, R arm 67.
95% RA, HR 68.
Settled post 20+ mg Morphine.
E4V5M6, hard of hearing, but compos mentis.

Working dx: Aortic Dissection.

POCUS: PLAX:

POCUS: AAA (Mid aorta, distal to SMA):

CT Diagnosis:

Final dx: Type A Aortic Dissection extending to common Iliac.

Disposition: Transferred to Tertiary center for Vascular/Cardiothoracic input.