Hidden Threads: Unusual Aortic Dissection Manifesting Through Abdominal Pain

Aortic dissection is an uncommon but life-threatening condition with a wide range of clinical presentations that can mimic other pathologies, often complicating timely diagnosis. Management strategies vary depending on the dissection type and clinical context. We report the case of a 34-year-old male with a history of uncontrolled hypertension with medication non-adherence who presented with dyspnea and abdominal pain after smoking marijuana. He was initially treated for flash pulmonary edema in the setting of a hypertensive emergency. However, due to persistence and worsening symptoms despite initial management, a CT of the chest was performed, revealing type A aortic dissection. The patient subsequently underwent emergent vascular surgery.