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Cardiomegaly and aortic dissection. The flap is seen involving the ascending aorta, without involvement of the coronaries, the arch and descending aorta and extends distally to the aortic bifurcation. Both false and true lumina are patent with no evidence of occlusion of any of the aortic branches. No sign of bowel ischemia or renal infarction. Bilateral pleural and minimal pericardial effusion are noted.