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Myocarditis mimicking acute aortic dissection. We report a case of myocarditis that closely mimicked acute aortic dissection in a young woman. The initial presentation was with sudden onset severe back pain and chest discomfort, associated with bilateral arm paraesthesia. The initial ECG demonstrated inferior ST-segment elevation with reciprocal anterior changes. The diagnosis was facilitated by urgent echocardiography, a CT aortogram and invasive coronary angiography to exclude aortic dissection and myocardial infarction, respectively. Acute myocarditis was later confirmed on cardiac MRI. The patient was treated conservatively with no subsequent arrhythmias with preservation of biventricular function.