title: Obstacles in the diagnosis of acute aortic dissection.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center, Israel. ybengal@inter.net.il
authors.forename: Yanai
authors.initials: Y
authors.lastname: Ben Gal
authors.forename: Dimitry
authors.initials: D
authors.lastname: Pevni
authors.forename: Yosef
authors.initials: Y
authors.lastname: Paz
authors.forename: Chaim
authors.initials: C
authors.lastname: Locker
authors.forename: Oren
authors.initials: O
authors.lastname: Lev-Ran
authors.forename: Nachum
authors.initials: N
authors.lastname: Nesher
authors.forename: Ariel
authors.initials: A
authors.lastname: Finkelstein
authors.forename: Gideon
authors.initials: G
authors.lastname: Uretzky
mesh_terms: 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*