Emergency Ultrasound: Identification of Aortic Dissection Using Limited Bedside Ultrasound
A case involving a 70-year-old woman presenting with acute chest pain highlights the utility of bedside ultrasound in rapidly diagnosing aortic dissection.
Emergency Medicine. 2017 March;49(3):135-137 | 10.12788/emed.2017.0017
March 7, 2017|Emergency Medicine
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Case Conclusion
After the results of the POC transthoracic and transabdominal ultrasound were reviewed, we promptly consulted the vascular surgery team. They performed a CT scan verifying a DeBakey type I aortic dissection involving both the ascending aorta and the descending aorta. The patient was subsequently taken to the operating room for definitive repair with a graft. She was discharged home on hospital day 9 in good condition.
Summary
Point-of-care ultrasound is a useful bedside tool for the rapid diagnosis of aortic dissection in the ED. The aortic root dilatation seen on the PSLA view and the presence of an intimal flap seen on either transthoracic or transabdominal views of the aorta are both highly sensitive for aortic dissection.
