eng Science and Education Publishing American Journal of Cardiovascular Disease Research 2016-08-12 4 1 11 14 10.12691/ajcdr-4-1-3 AJCDR2016413 article Ameen Mosa Mohammad doctoramb@yahoo.com 1 Shivan Umir Mohammed 2 Department of Internal Medicine, Faculty of Medical Sciences, University of Duhok, Kurdistan, Iraq Fellow in Internal Medicine, Duhok directorate of Health, Kurdistan, Iraq Here we present a case of 45 year old male who presented to the emergency department in Duhok, Kurdistan, Iraq in 2014 suffering of two hours sudden onset of dizziness and repeated vomiting. He had unremarkable past medical and drug histories apart of current smoking. On examination the patient was conscious, Pulse rate is 50 bpm and irregular, BP is 90/60 mmHg, evidence of audible murmur on heart auscultation, ECG showed slow atrial fibrillation, Cardiac enzymes were negative. Transthoracic echo (TTE) showed severe aortic regurgitation with a dissecting intimal flap in the ascending aorta. Chest CT-scan was ordered to confirm the dissection and then the patient underwent successful aortic dissection repair. A link between slow atrial fibrillation and aortic dissection has not previously recognized. http://pubs.sciepub.com/ajcdr/4/1/3/ajcdr-4-1-3.pdf aortic dissection slow atrial fibrillation transthoracic echocardiography Iraq