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EM@3AM: Abdominal Aortic Aneurysm

A 72-year-old male presents with left-sided flank pain for the last two weeks that has worsened over the past several hours. He also feels lightheaded when standing today. He is tachycardic to 124 beats per minute and hypotensive to 117/84 mm Hg relative to his chart baseline which has an average systolic in the 160s mmHg. You cannot reproduce his pain on your abdominal exam, but you feel a thrill with deep central abdominal palpation. What is the likely diagnosis, and what are your initial steps in evaluation and management?