In this episode, Dr. George Willis discusses the critical diagnosis and management of aortic dissection, emphasizing the importance of considering it in patients presenting with chest, back, and abdominal pain. Drawing from a case scenario and clinical experience, Dr. Willis highlights the challenges in diagnosing and managing aortic dissection, particularly when patients deteriorate rapidly. He provides practical insights into using ultrasound for diagnosis, the significance of resuscitation before intubation, and the cautious approach to pericardiocentesis. The episode underscores the necessity of early recognition and intervention to optimize patient outcomes in this high-stakes emergency.