[Acute aortic dissection: a challenging pitfall on the acute coronary syndrome pathway]

Acute aortic dissection is a life-threatening condition that is challenging and difficult to recognize since symptoms may mimic other time-dependent conditions like acute coronary syndrome, acute pulmonary embolism or abdominal conditions. We here describe the case of a middle-aged male with thoraco-abdominal pain, positive ECG and troponin tests that demonstrated a large type A aortic dissection at echocardiography done as part of the acute coronary syndrome work-up. This case report reminds clinicians that acute aortic dissection, although rare, should be considered as a differential diagnosis in the work-up of acute coronary syndrome to avoid critical pitfalls, and echocardiography is crucial to rule out it.