Inherited connective tissue diseases such as Marfan syndrome are frequently 
associated with cardiovascular manifestations. Aortic involvement with dilation 
and dissection is the most common finding and the major cause of death in Marfan 
syndrome patients. We report the echocardiographic study of a 53-year-old male 
patient with uncommon coexistence of cardiovascular abnormalities typical of 
connective tissue disease at first clinical presentation in acute clinical 
setting: dissection of the descending aorta associated with severe mitral 
regurgitation due to leaflet flail and massive aortic insufficiency due to 
ascending aortic enlargement, leading to left ventricular dilation and 
dysfunction.