Two dimensional echocardiographic diagnosis of aortic dissection

Bedside diagnosis of extensive aortic dissection

“…In spite of the drastically lower sensitivity of TTE (35-80%) [5][6][7][8] as compared to that of CT, MRI, or TEE, TTE has the advantage of being able to exclude other differential diagnoses in critically ill patients. Often, TTE is being performed to rule in or out these other diagnoses such as myocardial infarction when a dissection is discovered.…”

“…The discovered dissection was then traced origin of the aorta using a phased array probe utilizing both the standard TTE views and the suprasternal notch as a window to the superior portions of the aortic arch. With the use of multiple image planes including unusual imaging windows such as the right parasternal, left parasternal, and paraspinal, the thoracic aorta can be imaged in its entirety increasing the accuracy of TTE [6].…”

“…Radiologic imaging, however, is highly sensitive and specific with computerized tomography (CT), magnetic resonance imaging (MRI), trans-esophageal echocardiography (TEE), and angiography being the most sensitive [1]. In contrast, transthoracic echocardiography (TTE) has a sensitivity and specificity ranging from 35 to 80 and 39-96%, respectively, depending on the anatomic location of the dissection [5][6][7][8]. Yet, as more clinicians begin to use sonography at bedside, the characteristic signs of dissection, floating intimal membranes, the enlargement of the aortic root or arch, and an increase in the aortic wall thickness are occasionally encountered while the clinician is evaluating for other conditions [1].…”

The diagnosis of aortic dissection by emergency medicine ultrasound

“…Limited studies suggest that AD can be detected by either transthoracic or transabdominal ultrasound with a sensitivity of 67-80% (15)(16)(17)(18). Emergency ultrasound (EUS) has been shown to be useful in the diagnosis of abdominal aortic aneurysm (AAA) (19 -21).…”

Early identification of an atypical case of type A dissection by transthoracic echocardiography by the emergency physician

“…Transthoracic echocardiography has a sensitivity of 78% to 87% for diagnosing a type A dissection, 29% to 40% in diagnosing a type B dissection, with smaller studies showing nearly 100% sensitivity [7,8]. Transthoracic echocardiography provides a quick method of diagnosis with good sensitivity and specificity, and with the addition of suprasternal notch views visualizing the intimal flap improving the diagnostic accuracy with sensitivity and specificity of 67% to 80% and 99% to 100% [9][10][11][12].…”