Type A acute aortic dissection mimicking pulmonary embolism: intramural hematoma of the pulmonary arteries causing right heart pressure overload and hemoptysis

TAAAD is a rare but life-threatening cause of chest pain often mimicking other conditions such as pulmonary embolism. Pulmonary complications including intramural hematoma of the pulmonic trunk due to its shared adventitia with ascending aorta are rare but clinically significant, causing lumen reduction or occlusion of pulmonary arteries, leading to right heart pressure overload. Timely differentiation is critical as anticoagulation is contraindicated.