Aortic Dissection Echocardiography
- 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
- 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
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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