The usefulness of point-of-care ultrasound in the atypical presentation of aortic dissection: a case series and brief review of literature

Abstract

Acute aortic dissection represents a surgical emergency that, in most cases, may present an atypical and non-specific clinic, making the diagnosis difficult and late. Computed tomography angiography represents the gold standard for diagnosis, but different ultrasound techniques are able to provide valuable additional information related to diagnosis, and optimize therapy and prognostic assessment. In this case series, we describe different atypical patterns of aortic dissection, associated to non-diagnostic D-Dimer levels. These atypical conditions escape recognized diagnostic algorithms for the diagnosis of aortic dissection, although the incidence of such events is far from negligible. A clinical approach in the emergency setting that provides for a systematic and standardized use of bedside ultrasound could help reduce the incidence of errors and diagnostic delay, addressing the gold standard instrumental diagnostics for the reference pathology.