A 50 yrs old male patient,an alcoholic and smoker presents with a 3 hour history of severe retrosternal chest pain and increasing shortness of breath.He started having this pain while eating,which was constant and radiated to the back and interscapular region.He was a known hypertensive.On examination,he was cold and clammy with a heart rate of 130/min,and a BP of 80/40 mmHg.JVP was normal.All peripheral pulses were present and equal.Breath sounds were decreased at the left lung base and chest x-ray showed left pleural effusion.What is the most likely diagnosis?

• A. Acute aortic dissection
• B. Acute myocardial infarction
• C. Rupture of the esophagus
• D. Acute pulmonary embolism