A previously fit 21-year-old man presented with severel central chest pain. Clinical, electrocardiographic, and echocardiographic examination confirmed a dissection of an aneurysmal ascending aorta in the presence of previously undiagnosed severe aortic coarctation. Initial aortic dissection had occurred five days before admission. The medical and staged surgical management of the case are presented. Surgical survival with such a combination of lesions does not appear to have been previously recorded.
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