Abstract
Aortic dissection is an uncommon yet potentially deadly illness that frequently manifests acutely. However, some cases may remain undiagnosed until they become chronic, showing vague or non-specific symptoms. In cases where dissection is suspected, transthoracic echocardiography (TTE) is a reliable method for evaluating various aortic segments. This case report highlights an unusual case of chronic aortic dissection with acute decompensation in a 40-year-old male, who presented with the "double aortic valve sign" on TTE. LEARNING OBJECTIVES: Many patients with chronic aortic dissection present with vague signs and symptoms. Transthoracic echocardiography (TTE) is a useful imaging modality for evaluating various aortic segments in case of aortic dissection. Chronic aortic dissection manifesting as a "double aortic valve sign" on TTE is an extremely rare presentation.