What do Cardiologists Expect Regarding Echocardiogram in Aortopathies

Abstract

The echocardiogram is an available and essential imaging tool for the evaluation of thoracic aortic diseases. This examination plays a significant role in the identification and diagnosis, as well as the follow-up of chronic cases. Its availability, portability, costeffectiveness, and the absence of exposure to radiation or contrast make it an important tool for monitoring patients with known aortopathy, who usually require serial examinations for follow-up. Although it is inferior in the total and detailed characterization of the aorta in all its sections compared to aortic angiotomography or angioresonance, the echocardiogram allows for functional assessment of the aortic valve and valve apparatus. In acute aortopathies, it also enables the evaluation of complications and can be performed on hemodynamically unstable patients. This article will discuss the theoretical and practical aspects of the applicability of the echocardiogram in the context of aortopathies. Echocardiogram in AortopathiesThe echocardiogram is a crucial imaging tool for assessing the thoracic aorta and related diseases, being widely used for outpatient evaluation. 1,2 Given its broad availability in cardiological practice and the absence of screening recommendations for aortopathy in the general population, as well as the largest number of cases being asymptomatic and the high morbidity and mortality associated with the condition, this exam plays a vital role in identification and diagnosis. This is especially true for cases involving the proximal portions of the ascending thoracic aorta, which are better characterized using echocardiography. The exam's availability, portability, cost-effectiveness, and lack of radiation or contrast exposure make it invaluable for monitoring patients with known aortopathy, who often require regular followup exams. While echocardiography is not as comprehensive as CT angiography or magnetic resonance angiography for aortic assessment, it provides functional evaluation of the aortic valve and apparatus. In acute aortopathies cases, it can also assess complications, being feasible even in hemodynamically unstable patients. The main uses of echocardiography in aortopathy settings are summarized in Central Illustration.