The clinical presentation of a dissecting aoic aneurysm mimics that of a myocardial infarction; however, electrocardiographic changes and increased concentration of cardiac enzymes are notably absent. The mediastinum is often widened by radiographic examination. Although there is an association with hypeension and disorders of connective tissue (e.g., Marfan syndrome and Ehlers-Danlos syndrome), there is no association with atherosclerosis. The presentation exemplified by this scenario is a true surgical emergency!