Session Title: Acute Aortic Dissection: A Case-Based Approach to Rapid Diagnosis and Management\nTarget Audience: Third-year Physician Assistant students\nSession Duration: 90 minutes\nLearning Outcomes:\n* Analyze the clinical presentation of acute aortic dissection and differentiate it from other causes of acute chest pain.\n* Formulate an immediate diagnostic and management plan for a patient with suspected acute aortic dissection.\n* Discuss the interprofessional communication strategies and ethical considerations pertinent to the rapid management of critical cardiovascular emergencies.\nPre-Work (15-30 minutes estimated):\n* Review of cardiovascular anatomy and physiology, focusing on the aorta.\n* Readings: Current guidelines on the diagnosis and initial management of acute aortic syndromes (e.g., AHA/ACC guidelines executive summary).\n* Watch: Short video (5-7 min) on the pathophysiology of aortic dissection.\nMaterials Needed:\n* Whiteboard or flip chart\n* Projector for case presentation slides\n* Handouts with key lab results and imaging (if not projected)\n* Markers\nSession Opening (10 minutes):\n* Brief introduction (2 min): Welcome, overview of session goals, and connection to Acute Aortic Dissection: A Case-Based Approach to Rapid Diagnosis and Management and To recognize atypical presentations of acute cardiovascular emergencies; to formulate a rapid diagnostic and management plan for suspected aortic dissection; to discuss the interprofessional communication required in critical care settings.\n* Hook (8 min): Present the initial patient scenario (Mr. J, a 68-year-old male presenting with sudden onset of severe, tearing chest pain radiating to his back. He has a history of uncontrolled hypertension and Marfan syndrome. On examination, his blood pressure is significantly elevated (180/100 mmHg) in his right arm but notably lower (110/70 mmHg) in his left. His pulse is rapid and thready. A new, faint diastolic murmur is appreciated at the right sternal border. Peripheral pulses are diminished in the left lower extremity.) and ask students for their initial thoughts on the differential diagnosis. "What are your immediate concerns based on this initial presentation? What life-threatening conditions come to mind?"\nCore Segments (60 minutes):\n* Segment 1: Case Presentation & Initial Hypotheses (20 minutes)\n * Present key aspects of Mr. J's initial presentation.\n * Prompts: "Based on the vital signs and physical exam findings, what is your leading differential diagnosis? What further diagnostic tests would you order immediately, and why? What are your immediate management priorities for Mr. J, even before definitive diagnosis?"\n* Segment 2: Data Analysis & Refinement (20 minutes)\n * Introduce new data: ECG shows sinus tachycardia, no acute ischemic changes. Initial labs show elevated D-dimer. Chest X-ray reveals a widened mediastinum. Discuss the need for a CT angiogram.\n * Prompts: "How do these new findings influence your differential diagnosis? What specific information are you seeking from the CT angiogram? If the CT confirms an acute Type A aortic dissection, how does this change your immediate management plan?"\n* Segment 3: Management & Ethical Considerations (20 minutes)\n * Focus on long-term management, patient education, interprofessional collaboration, or ethical dilemmas presented by Mr. J's case. Discuss surgical vs. medical management options, and the critical role of interprofessional teams.\n * Prompts: "Considering Mr. J's age and co-morbidities, what are the critical components of the pre-operative and post-operative management plan? What ethical considerations might arise when discussing treatment options or prognosis with Mr. J and his family? How would you ensure effective communication between the emergency department, cardiology, cardiac surgery, and nursing teams?"\nActive Learning Task (10 minutes):\n* Small-Group Discussion: Divide students into groups of 3-4. Each group role-plays a brief (5-minute) huddle between an ED physician, a cardiac surgeon, and a critical care nurse, discussing the immediate transfer and stabilization plan for Mr. J, focusing on clear communication of critical information and roles.\nAssessment / Wrap-up (10 minutes):\n* Summary (5 min): Reiterate key clinical pearls regarding the diagnosis and management of aortic dissection, linking back to To recognize atypical presentations of acute cardiovascular emergencies; to formulate a rapid diagnostic and management plan for suspected aortic dissection; to discuss the interprofessional communication required in critical care settings.\n* Q&A (3 min): Open floor for questions.\n* Formative Assessment (2 min): Ask students to write down one key diagnostic sign or symptom of aortic dissection that they will remember from today's session ("one-minute paper").\nFollow-up Readings / Resources:\n* Review article: "Acute Aortic Dissection: An Update on Diagnosis and Management." (e.g., Circulation, recent edition)\n* Case studies: Additional anonymized cases of aortic dissection with varying presentations.\n* Online module: Interactive module on Interprofessional Communication in Critical Care.