Background: Early diagnosis of Acute Aortic Dissection (AAD) can be a challenge for emergency physicians given its unspecific and variable presentation. For this reason, it is frequently referred to as "the great imitator," as it can mimic so many other conditions, including acute coronary syndrome and stroke. Case Presentation: We report a middle-aged male who presented to the Emergency Department (ED) with complaints of dizziness. His vitals showed differences in blood pressure (BP) between both arms and an absent pulse in the right arm. a computerized tomographic (CT) angiography of the aorta, which showed a Stanford type A aortic dissection. The patient was in stable condition until he was transferred to another health care facility for further care and intervention. AAD is a challenging diagnosis to make in the ED and has a high mortality rate, especially if there is a delay in diagnosis and definitive management. Conclusion: So far, there are no blood tests available that accurately rule in or rule out AAD. While bedside transthoracic echocardiography can be used as an adjunct test in unstable patients, computerized tomographic (CT) angiography remains a pragmatic reference standard for the diagnosis of AAD.

Keywords: Case report, Aortic, Dissection, ED, AAD.