Aortic Dissection Echocardiography
OVERVIEW
- TOE is better than but TTE, but TTE can be performed first
- TTE cannot exclude aortic dissection
- TOE is comparable to CT and MRI for diagnostic accuracy
ECHO FINDINGS
- intimal flap
- can “type” the dissection: type A associated features and complications:
- aortic regurgitation (acute dilatation of the aortic root, aortic leaflet prolapse, dissection flap prolapse, pre-existing disease, e.g. bicuspid valve)
- pericardial effusion and/or tamponade
- regional wall motion abnormality heralding coronary artery occlusion
- colour flow Doppler
- identifies true and false lumen
- detect aortic branch occlusion/ dissection (absent flow)
ACUTE AORTIC SYNDROMES
- aortic dissection
- intramural haematoma (IMH)
- penetrating atherosclerotic ulcer
- traumatic transection (distinct pathogenesis to the others)
References and Links
- Meredith EL, Masani ND. Echocardiography in the emergency assessment of acute aortic syndromes. Eur J Echocardiogr. 2009 Jan;10(1):i31-9. PMID: 19131497
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
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