Most commonly seen in men 60-80 yrs old
Intimal tear with blood leaking into media
Mortality increases 1% per hour of symptoms when untreated
Diagnosis delayed > 24hr in 50% of cases
Bimodal age distribution
Young with risk factors
Connective tissue disease (e.g. Marfan syndrome, Ehler's-Danlos, collagen vascular disease)
Pregnancy, especially 3rd trimester
Recent cardiac catheterization
Bicuspid<unk>  valve<unk>  coarctation
Elderly males with chronic hypertension
Atherosclerotic risk factors (smoking, hypertension, HLD, DM)
Young with risk factors
Connective tissue disease (e.g. Marfan syndrome, Ehler's-Danlos, collagen vascular disease)
Pregnancy, especially 3rd trimester
Recent cardiac catheterization
Bicuspid<unk>  valve<unk>  coarctation
Elderly males with chronic hypertension
Atherosclerotic risk factors (smoking, hypertension, HLD, DM)
Connective tissue disease (e.g. Marfan syndrome, Ehler's-Danlos, collagen vascular disease)
Pregnancy, especially 3rd trimester
Recent cardiac catheterization
Bicuspid<unk>  valve<unk>  coarctation
Nontraumatic thoracic aortic dissection
Acute coronary syndromes 
Coronary artery dissection
STEMI
Left ventricular aneurysm
Non-STEMI
Left ventricular pseudoaneurysm
Unstable angina