We present the clinical case of an 80-year-old woman admitted to the emergency department with jaw pain and acute neurovascular impairment with right arm monoparesis, pulse deficit and pallor of the limb, without chest pain as a cardinal symptom.The history of arterial hypertension, aortic stenosis, and clinical manifestation suggested an acute vascular compromise, for which acute aortic syndrome (AAS) was suspected.Chest x-rays revealed mediastinal widening; angio-CT scan confirmed type-A aortic dissection affecting the right subclavian artery (thrombosis).The patient passed away after expectant non-surgical management.