Thoracic aortic coarctation is a clinically critical condition that requires urgent management. It is relatively common in men and often has a history of hypertension and smoking for many years. Patients often complain of severe chest and back pain, which is knife-like and radiates downward. The chest pain often occurs so suddenly that the patient can clearly recall the onset of chest pain. If the aneurysm ruptures 121 in the ascending aorta, it may affect the blood supply to the innominate artery or the left subclavian artery, resulting in a weakened or even absent pulse. Therefore, patients with chest pain combined with pulselessness should be on high alert for entrapment aneurysms, and the simple method of checking for a pulse can indicate a significant number of cases. If no attention is paid to the differential diagnosis, misdiagnosis of such patients as coronary artery disease and administration of antiplatelet and anticoagulation therapy can have disastrous consequences.