A 65-year-old man presented to the emergency department complaining of severe tearing chest pain radiating to the back, unrelieved by analgesics. It started a few hours ago, with nausea, vomiting, and excessive sweating. The patient is a known case of essential hypertension since he was 25 years old. He is not compliant with his drugs. He has COPD with 35-pack-year smoking history. He has chronic kidney disease. On examination, BP 200/100, Heart rate 120 pulse/min, O₂ sat 98%. ECG showed signs of left ventricular hypertrophy, with no ischemic changes. He has normal chest expansion bilaterally, with normal tactile fremitus and normal breath sounds. What is the most likely diagnosis?

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Eductional Objective: Aortic Dissection presents with sudden onset severe tearing chest pain radiating to the back. The major group of patients affected include patients with hypertension, bicuspid aortic valve, and inherited connective tissue disorders.

A 65-Year-Old Man Presented to the Emergency Department Complaining of Severe