Acute aortic syndromes (AASs), including aortic dissection (AD), intramural aortic haematoma (IMH) and penetrating aortic ulcer (PAU), affect 5–7/100,000 individuals/year [1]. They are time-dependent emergencies burdened by up to 1–2 % mortality/hour, if left untreated. AASs cause unspecific symptoms such as chest/abdominal/back pain, syncope, neurological deficits and limb ischemia. Large numbers of patients are evaluated in Emergency Departments (EDs) for these common symptoms, but only few of them have an AAS, e.g.