title: Role of transesophageal echocardiography in patients with suspected aortic dissection.
abstract: Patients with acute aortic dissection of the ascending aorta benefit from rapid surgical intervention. We report a patient with suspected acute aortic dissection based on history and transthoracic echocardiography findings. This patient was taken to the operating room without further workup, where transesophageal echocardiography (TEE) revealed acute myocardial infarction and mitral regurgitation due to papillary muscle rupture. The patient underwent coronary bypass grafting and mitral valve replacement. This case demonstrates that intraoperative TEE can be used as a primary diagnostic modality to rule out aortic dissection, and can provide a definitive etiology for cardiogenic shock before a planned surgical intervention.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Tüebingen University Hospital, Tüebingen, Germany. heltzschig@partners.org
authors.forename: Holger K
authors.initials: HK
authors.lastname: Eltzschig
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenberger
authors.forename: Robert W
authors.initials: RW
authors.lastname: Lekowski
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Scott
authors.forename: Andrew
authors.initials: A
authors.lastname: Locke
authors.forename: Prem S
authors.initials: PS
authors.lastname: Shekar
authors.forename: Stanton K
authors.initials: SK
authors.lastname: Shernan
authors.forename: John A
authors.initials: JA
authors.lastname: Fox
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging*; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging* / Q000209:etiology*; D014463:Ultrasonography