A 51-year-old man walked into the emergency room with chest pain. The symptoms seemed clear enough: elevated blood pressure, chest discomfort, some cardiac irregularities. The emergency physician, attending doctor, and cardiologist all converged on the same diagnosis—acute coronary syndrome or accelerated hypertension. The classic signs of anything more serious simply weren’t there.But one hospitalist wasn’t satisfied. Despite multiple colleagues ruling out aortic dissection as unlikely, somethi...