Iatrogenic aortic dissection caused by coronary angiography or angioplasty is a rare but potentially life-threatening complication. Awareness of the complication and its prompt recognition are important. We describe a 78-year-old woman who underwent coronary angioplasty for acute non-ST elevation myocardial infarction. An ostial dissection of the right coronary artery (RCA) with extension into the entire ascending aorta occurred during the an attempt to recanalize an occluded RCA. The literature recommends surgical intervention or stenting of the coronary dissection under these circumstances. However, the patient was managed conservatively. Serial evaluation with noninvasive imaging studies showed resolution of the ascending aortic dissection.