Acute type A aortic dissection with left main coronary involvement

Abstract A 74-year-old man presented with abrupt chest and back pain, shock, and electrocardiographic features of global subendocardial ischaemia. Computed tomography angiography identified acute Stanford type A aortic dissection extending into the left main coronary artery with near-complete obstruction, underscoring the need to consider aortic dissection before invasive coronary angiography when left main-like electrocardiographic findings are accompanied by tearing back pain and haemodynamic collapse.