“…Aside the peculiar symptomatology, that in our case contributed, in a crucial way, to direct toward the solution of the clinical puzzle, it should be remembered that, even supraventricular AR, can sometimes be “only” epiphenomena of hypoxia. Indeed, AF is not rare in AAD, we suppose that the reduction of the oxygen supply to the sinoatrial nodal artery, that in 80% of the people origin from the right coronary, could induce arrhythmias. Finally, in order to reduce the time from diagnosis to surgery, that it is known to cut down the mortality of 50% in the first 48 hours, in our opinion, it is important to consider the supraventricular arrhythmias, alone with the D‐dimer that has been recently included, to the ADDRS to assess the susceptibility to develop arrhythmias…”