Pleuropericardial Decompression Masking Cardiac Tamponade in Acute Type A Aortic Dissection

What is already known: Cardiac tamponade is a major cause of pulseless electrical activity arrest in acute type A aortic dissection.What is new: CPR-associated pericardial rupture may decompress tamponade into the pleural cavity, producing massive hemothorax with paradoxically minimal pericardial effusion on post-resuscitation CT-a critical imaging pitfall in ATAAD.