Hickam’s Dictum of the Great Vessels: Saddle Embolism and Dissection

History of Present Illness Chief Complaint:Shortness of breath History of Present: Illness A 66-year-old female with a past medical history of hypertension presents to the emergency department concerned for shortness of breath and palpitations. She reports her symptoms started abruptly while on a morning walk. She notes she took her home blood pressure medication this morning per her usual routine and had otherwise been feeling well. She describes feeling like she is having a “high grade panic attack”, similar to past panic attacks but with increased intensity. She denies associated weakness, numbness, chest pain, nausea, vomiting, or abdominal pain. She reports no recent immobilization, surgery, or hormone use.