Localized Aortic Dissection: Unusual Features by Transesophageal Echocardiography

Abstract

Transesophageal echocardiography relies on the presence of an undulating intimal flap for the diagnosis of aortic dissection. Furthermore, to distinguish true dissection from echo artifacts, the flap has to be identified in more than one view, and it must have a motion independent of the aortic wall. We describe the transesophageal echocardiography appearance of a localized aortic dissection with atypical features for an intimal flap. Awareness of this unusual echocardiographic appearance of an intimal flap will avoid misdiagnosis of the poten-tially serious acute aortic dissection. (J Am Soc Echo-cardiogr 2000;13:1130-4.)