This document discusses acute aortic syndrome, including a case presentation of a 55-year-old female with chest pain. Key details include: 1. The patient presented with sudden onset chest pain and was found to have hypertension on examination. 2. Initial workup including ECG, labs and chest x-ray were non-diagnostic but showed a widened mediastinum. 3. Echocardiogram and CT angiogram revealed an aortic dissection involving the aortic arch and descending thoracic aorta. 4. She was referred urgently for cardiovascular surgery to treat this life-threatening condition within 24 hours of presentation.