Aortic dissection is the most common fatal condition that involves the aorta. Occasionally, symptoms mimic acute myocardial infarction leading to thrombolytic treatment which may have lethal consequences in aortic dissection. Thus, accurate diagnosis in patients with chest pain is therefore essential. We present a case of acute myocardial infarction which resulted from the acute aortic dissection with obstruction of the left and right coronary ostia by intimal flap. Transesophageal echocardiography was used as the diagnostic tool.