Abstract Thrombolysis, a standard therapy for ST elevation myocardial infarction (STEMI) in non-PCI-capable hospitals, may be catastrophic for Chrysin patients with aortic dissection leading to further expansion, rupture and uncontrolled bleeding.Stanford type A aortic dissection, rarely may mimic myocardial infarction.We report a case of a patient with an inferior STEMI thrombolysed with tenecteplase and followed by clinical and electrocardiographic evidence of successful reperfusion, which was found later to be a lethal acute aortic dissection.Prognostic implications of early diagnosis applying Hat transthoracic echocardiography (TTE) are described.