eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-01-14 9 3 180 183 10.12691/ajmcr-9-3-12 AJMCR20219312 article Parinaz Ayat 1 Bridget Ayinbono Azera 1 Suzette Blondelle graham-Hill 1 Andrea Trimmingham 1 Samy I. McFarlane Smcfarlane@downstte.edu 1 Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States- 11203 Acute Aortic dissection is relatively uncommon but can lead to fatal outcome due to misdiagnosis and/or delay treatment [1]. In this report we present a case of a 45-year-old man presenting with chief complaint of substernal chest pain with no remarkable laboratory and echocardiography finding. He was admitted to the cardiology service with clinical suspicion of acute coronary syndrome (ACS). However, further evaluation led to the diagnosed of acute aortic dissection and referral for urgent repair. Aortic dissection could mimic other disorders such as ACS and pulmonary embolism due to variation in the presenting symptoms [1]. Therefore, high clinical suspicious could lead to timely diagnosis and initiation of life-saving therapeutic interventions. http://pubs.sciepub.com/ajmcr/9/3/12/ajmcr-9-3-12.pdf chest pain aortic dissection acute coronary syndrome atypical presentation Stanford classification type A