Obstacles in the diagnosis of acute aortic dissection.
Acute aortic dissection (AAD) is a life-threatening condition for which prompt diagnosis is essential for successful management. The imaging modalities for demonstrating the dissecting membrane include retrograde aortography, contrast-enhanced computed tomography (CT), transesophageal echocardiography (TEE), and magnetic resonance imaging. Of these, aortography had long been considered the gold standard in diagnosing aortic dissection. We present a case of AAD in which contrast-enhanced CT and retrograde aortography failed to demonstrate an aortic membranous flap, whereas TEE swiftly provided clear-cut evidence of the pathology. TEE should be considered when AAD is suspected despite negative findings on other imaging modalities.
Ben Gal
Yanai
Y
Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, Israel. ybengal@inter.net.il
Pevni
Dimitry
D
Paz
Yosef
Y
Locker
Chaim
C
Lev-Ran
Oren
O
Nesher
Nachum
N
Finkelstein
Ariel
A
Uretzky
Gideon
G
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005188:False Negative Reactions; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods*