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AKT1-113

A 55 year old man presents with a 4 hour history of severe sharp central chest pain radiating to his neck and abdomen. He is sweating and his heart rate is 98. His left arm blood pressure is 136/89 and his right arm blood pressure is 114/80. You hear a diastolic murmur on auscultation. Which one of the following is the most likely diagnosis?

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