The Assessment of Aortic Dissections

Don't Miss This Urgent Echo Finding

The Basics

The aorta consists of three layers — the inner layer (intima), the middle layer (media), and the outer layer (adventitia). When there is a weakening of the inner layer, a tear can occur and allows blood to pass between the intima and the media. This separation is referred to as a dissection and is a life-threatening condition that we evaluate with echocardiography. There are 5 video case examples included in this article for a comprehensive understanding on both TTE and TEE.

Role of Echocardiography

We visualize the aorta in multiple imaging windows: the parasternal long axis, parasternal short axis, apical, subcostal, suprasternal notch, and of course the right parasternal view. Off-axis imaging is recommended and tools like x-plane are encouraged to thoroughly investigate the intimal flap.