Diagnosis of Ascending Aortic Dissection Using Emergency Department Bedside Echocardiogram
Article first published online: 9 JUN 2008
© 2008 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 15, Issue 6, page 584, June 2008
How to Cite
Budhram, G. and Reardon, R. (2008), Diagnosis of Ascending Aortic Dissection Using Emergency Department Bedside Echocardiogram. Academic Emergency Medicine, 15: 584. doi: 10.1111/j.1553-2712.2008.00106.x
- Issue published online: 9 JUN 2008
- Article first published online: 9 JUN 2008
A 36-year-old white male with history of hypertension and schizophrenia presented to the emergency department (ED) with several hours of severe throat pain and shortness of breath that began abruptly while climbing stairs. Examination revealed a severely agitated, pale, diaphoretic patient who was vomiting. The patient’s pulse was noted to be 100 beats/min, with blood pressure 70/35 mmHg. Examination of the oropharynx and neck was unremarkable. Examination of the chest revealed only occasional rales and tachycardia. A chest radiograph revealed cardiomegaly and pulmonary edema. An ED bedside echocardiogram was performed by an emergency physician. Significant aortic root dilatation was seen on a parasternal long axis view (Figure 1). An intimal flap extending around the aortic arch was visualized on a suprasternal view (Figure 2). Surgery was immediately consulted and the patient was taken to the operating room. In this case, early ultrasound diagnosis (videos available as online Data Supplements at <link removed as it refers to this location>) led to prompt operative intervention, and the patient was ultimately discharged from the hospital several weeks later.
Video Clip S1. Aortic dissection PSLA.
Video Clip S2. Aortic dissection suprasternal.
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