Acute aortic dissection is a life threatening illness requiring early diagnosis and treatment. Management of this disease incorporates not only emergency department personnel, but also the medical, surgical, and intensive care specialties. If left untreated, the mortality rate of acute aortic disease exceeds 50% within 48 hours and 80% wilhin 2 weeks, with a 5-year survival rate of 19%. The most common cause of death in untreated acute aortic dissection, regardless of etiology, is aortic rupture. In this article, the author reviews: the incidence and pathology; etiology; clinical manifestations; diagnostic workup; patient care management (medical and surgical); and follow-up care of acute aortic dissection, bath ascending and descending

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