Transthoracic Echocardiographic Findings of Stanford Type A Aortic Dissection: A Case Report

Abstract

Aortic dissection is a well-known, but relatively uncommon diagnosis in the emergency department (ED). With a mortality rate as high as 30 percent, it is important to be able to diagnose quickly and accurately. Definitive diagnosis with imaging studies such as computed tomography angiogram (CTA) can be expensive and time-consuming and may not always be available in the community. Herein, we discuss a case of a 59-year-old man presenting with severe chest pain, hypotension, and bradycardia who was diagnosed with aortic dissection first by bedside ultrasound. This expedited the CTA and a cardiothoracic surgery consult, leading to a successful emergent aortic repair.

Use of Point-of-Care Ultrasound for Early Identification of Acute Aortic Root Dissection

“…Acute thoracic aortic dissection is a rare condition with an annual incidence of 3 per 100,000 individuals [ 4 ]. The mortality rate ranges from 18 to 30% [ 4 , 5 ].…”

“…Acute thoracic aortic dissection is a rare condition with an annual incidence of 3 per 100,000 individuals [ 4 ]. The mortality rate ranges from 18 to 30% [ 4 , 5 ]. The Stanford classification system is widely accepted and differentiates types of dissection by location; a Stanford type A dissection involves the ascending aorta, whereas a Stanford type B type involves the descending aorta [ 6 ].…”

Aortic Dissection Presenting as Leg Pain

“…Aortic dissection is a surgical emergency with an incidence of three per 100,000 and a mortality rate of 25% to 30% [1][2][3][4]. Sudden onset tearing chest pain is the classic presentation, but aortic dissection can have a variable presentation due to the aorta's anatomic course.…”