A 55-year-old man with An aortic dissection.

A 55-year-old man presented to a community hospital with a chief complaint of possible seizure and altered mental status. Emergency medical services (EMS) had found him as the sole occupant of his car, which had been pulled over to the side of the road with no sign or report of trauma. On EMS arrival, the patient was noted to be bradycardic into the 50s with a weak, thready radial pulse and unobtainable blood pressure.