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Acute myocardial ischemia and infarction from retrograde dissection of the aortic root into the coronary ostia is a potentially fatal condition. Unrecognized type A aortic dissection at the time of angiography for acute coronary syndrome (ACS) carries a high burden of morbidity and mortality. Cardiac computed tomography angiography (CCTA) has emerged as one of the instrumental tools in the diagnosis of retrograde coronary involvement from type A aortic dissections. We present a case of ACS secondary to retrograde aortic dissection exten
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