Thoracic Aortic Dissection A difficult to diagnose, uncommon, and potentially fatal condition: Emergency Medicine at its finest!   Let’s talk about a patient we think see every day in the ED. A man comes in complaining of chest pain with elevated blood pressure of 200/90 upon triage. The ECG shows sinus bradycardia with inferior and lateral T-wave inversions. The CXR and troponin are unremarkable. The patient is low risk for PE, and there is no pneumothorax or pneumonia, so this patient is an easy disposition to either home or observation unit depending on whether you want to "rule out ACS", right?

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