Abstract: A 40 year old female was brought for post mortem examination with history of epigastric pain of one day duration followed by death after hospitalisation on the very same day. She was unmarried & had mild mental retardation but she was capable of doing household chores. She also had recurrent episodes of epigastric pain for last 1 year for which she was treated with antacids. On examination pericardial tamponade was found as the cause for death. Detailed examination of heart & histology revealed associated bicuspid Aortic valve & Stanford type A aortic dissection.