What started as a suspected STEMI turned out to be something far more catastrophic. This case takes us inside the emergency hospitalization of an 85-year-old male who collapsed at home, later found to have a ruptured infrarenal abdominal aortic aneurysm. With intubation, central line placement, and emergent endovascular repair, this is a deep dive into rapid response, cross-disciplinary coordination, and critical decision-making.

But the story doesn’t stop in the OR—acute kidney injury, persistent low-grade fevers, and an unexpected gout flare complicated this patient’s post-op course. How do you balance aggressive life-saving interventions with the nuanced challenges of post-op management in older adults?

Key Topics for Clinical Learning:

• Emergency Presentation & Initial Misdiagnosis
  → Differentiating STEMI-like symptoms from AAA rupture in older adults.

• Rapid Interventions & Surgical Management
  → Intubation, central access, and endovascular repair for AAA.

• Post-Op Complication Management
  → AKI protocols, febrile workups, and managing comorbidities like gout in the acute setting.

• Discharge Planning & Rehab Goals
  → Transitioning from ICU to rehab: setting expectations for functional recovery and long-term monitoring.