Aortic Dissection in Progress Diagnosed by Transthoracic Echocardiography

This report describes a patient who presented with vague chest pain, syncope, and seizures. The diagnosis of dissection of the ascending aorta was clearly established by transthoracic echocardiography. The dissection was initially limited to the ascending aorta. Using the suprasternal window, it was possible to monitor the progression of the dissection almost beat by beat as it extended from the ascending aorta and across the aortic arch to the descending thoracic aorta. Surgical intervention was carried out immediately with successful results. Although transesophageal echocardiography is the procedure of choice in aortic dissection, definitive information can be obtained quickly and safely using the transthoracic approach. The suprasternal window in this case showed the dramatic progression of the disease process.