<s>[INST] context: The peak incidence of aoic dissection is in the sixth and seventh decades. Men are more affected than women by a ratio of 2:1. The presentations of aoic dissection and its variants are the consequences of intimal tear, dissecting hematoma, occlusion of involved aeries, and compression of adjacent tissues.Acute aoic dissection presents with the sudden onset of pain , which often is described as very severe and tearing and is associated with diaphoresis. The pain may be localized to the front or back of the chest, often the interscapular region, and typically migrates with propagation of the dissection. Other symptoms include syncope, dyspnea, and weakness. Physical findings may include hypeension or hypotension, loss of pulses, aoic regurgitation, pulmonary edema, and neurologic findings due to carotid aery obstruction (hemiplegia, hemianesthesia) or spinal cord ischemia (paraplegia). Bowel ischemia, hematuria, and myocardial ischemia have all been observed. These clinical manifestations reflect complications resulting from the dissection occluding the major aeries. Fuhermore, clinical manifestations may result from the compression of adjacent structures (e.g., superior cervical ganglia, superior vena cava, bronchus, esophagus) by the expanding dissection, causing aneurysmal dilation, and include Horner's syndrome, superior vena cava syndrome, hoarseness, dysphagia, and airway compromise. Hemopericardium and cardiac tamponade may complicate a type A lesion with retrograde dissection. Acute aoic regurgitation is an impoant and common (>50%) complication of proximal dissection. It is the outcome of either a circumferential tear that widens the aoic root or a disruption of the annulus by a dissecting hematoma that tears a leaflet(s) or displaces it, inferior to the line of closure. Signs of aoic regurgitation include bounding pulses, a wide pulse pressure, a diastolic murmur often radiating along the right sternal border, and evidence of congestive hea failure. The clinical manifestations depend on the severity of the regurgitation. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2057 [/INST] question: Manifestations of aoic dissection are - | options: A: Pericardial effusion B: AR C: MR D: AMI | answer: C </s>