This could be a terrifying case for first and second year radiology residents, or even practicing radiologists to take on-call, particularly when tired. This life-threatening finding of aortic dissection with possible early rupture is barely noticeable when focussing on the evaluation for acute pulmonary embolus. This case provides a great reminder to perform as detailed as possible of an evaluation of the entire chest, even when performing a directed study such a CTA for PE. 

The patient underwent successful graft repair of the ascending aorta.