question: Q:A 59-year-old man presents to the emergency department with a sudden onset of severe pain (10/10 in severity) between the shoulder blades. He describes the pain as tearing in nature. Medical history is positive for essential hypertension for 11 years. The patient has smoked 10–15 cigarettes daily for the past 30 years. His temperature is 36.6°C (97.8°F), the heart rate is 107/min, and the blood pressure is 179/86 mm Hg in the right arm and 157/72 mm Hg in the left arm. CT scan of the chest shows an intimal flap limited to the descending thoracic aorta. Which of the following best describes the most likely predisposing factor for this condition?? 
  {'A': 'Abnormal elastic properties of the aorta', 'B': 'Coronary atherosclerosis', 'C': 'Aortic coarctation', 'D': 'Aortic atherosclerosis', 'E': 'Hypertensive urgency'},