Focused cardiac ultrasound diagnosis of thoracic aortic aneurysm: two cases.
BACKGROUND
Thoracic aortic aneurysms (TAAs) are less prevalent than abdominal aortic aneurysms. Symptomatic TAAs need to be identified quickly by the emergency physician (EP) since mortality rates increase dramatically once complications such as rupture or dissection occur. Compared with validated EP-performed ultrasound of the abdominal aorta, EP-performed focused cardiac ultrasound that includes evaluation of the thoracic aorta is relatively unreported.


OBJECTIVE
Two cases illustrate EP-performed focused cardiac ultrasound and evaluation of the thoracic aorta for aneurysmal dilation. CASE


METHODS
(1) A 60-year-old man presented to the emergency department (ED) after a blunt traumatic injury to his back while at work. During the focused cardiac ultrasound examination, the aortic outflow tract distal to the aortic valve appeared enlarged and the aortic root measured 5.49 cm. (2) An 82-year-old man with hypertension presented to the ED with 1 month of chest pain radiating to the back. The focused cardiac ultrasound examination demonstrated enlargement of the descending thoracic aorta at 4.82 cm.


CONCLUSIONS
EPs performing focused cardiac ultrasound can visualize regions of the thoracic aorta that may reveal an aneurysm, particularly in the parasternal long axis view.
Department of Emergency Medicine, Emergency Medicine Residency Program, Lincoln Medical & Mental Health Center, Bronx, New York.
Michael C
MC
Daignault
Emergency Ultrasound Division, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York.
Turandot
T
Saul
Emergency Ultrasound Division, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York.
Resa E
RE
Lewiss
D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D004635:Emergency Medicine; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011859:Radiography
emergency department; focused cardiac ultrasound; thoracic aortic aneurysm