Abstract
Acute aortic dissection (AAD) is a fatal cardio-vascular emergency initiated by an intimal breach in the aorta, leading to the delamination of its wall layers and the development of true and false lumina. Typically, Stanford Type B dissections are amenable to medical management unless complications develop. This report describes a 45-year-old hypertensive male who presented with acute, severe, constricting chest pain. Physical assessment identified a notable inter-arm blood pressure discrepancy. Emergency Computed Tomography Angiography (CTA) confirmed an acute Stanford Type B AAD, originating post to left subclavian artery and extending into the abdominal aorta and right common iliac artery, accompanied by mediastinal and pericardial hemorrhage. The patient promptly received aggressive medical therapy to stabilize hemodynamics (blood pressure and heart rate reduction) and was urgently transferred to a specialized cardio-thoracic intensive care facility. This case highlights the paramount importance of swift diagnosis and effective hemodynamic stabilization in managing acute aortic dissections.