Aortic Dissection with Acute Aortic Regurgitation

This week’s image of the week is brought to us by Drs. Towater and Shayne. Dr. Towater used ultrasound to diagnose a massive aortic aneurysm that stretched from the ascending aortic root all the way to bifurcation of the iliac vessels. Demonstrating an even higher level of skill, she applied color doppler to her PSL (Parasternal  Long Axis View) and found that the patient had acute aortic regurgitation. 

 LVOFT = Left ventricular outflow tract. 

As this finding was suggestive of a possible concomitant aortic dissection, she continued to pursue this diagnosis with a CT scan and a TEE.  As mentioned in prior images of the week, TTE is not the diagnostic modality of choice for an aortic dissection.  TEE or CT are preferred. However, bedside TTE can aid greatly in diagnosing aortic pathology.

For more information on aortic dissection, check out:

Acute aortic dissection.

Kamalakannan D, Rosman HS, Eagle KA.

Crit Care Clin. 2007 Oct;23(4):779-800, vi. Review.

PMID:17964363