Abstract
A 55-year-old female with a history of hypertension was admitted for dyspnea, epigastralgia and nausea. A chest X-ray showed pulmonary congestion. Transthoracic echocardiography (TTE) revealed severe left ventricular dysfunction with akinesis of the infero-posterior wall and Doppler color-flow mode showed mild aortic regurgitation (AR). Noninvasive positive pressure ventilation, intravenous heparin and diuretics were administered. Follow-up TTE revealed a dissection flap as well as momentary and wide AR only during isovolumetric relaxation. Contrast-enhanced computed tomography of the chest revealed Stanford type A aortic dissection. A momentary and wide AR in echocardiograms might serve as an important and useful indicator of aortic dissection in patients with acute myocardial infarction and congestive heart failure.
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Video. Transthoracic echocardiography. Findings show momentary and wide aortic regurgitation, mild mitral regurgitation and dissection flap that moves in synchrony with the aortic valve. (MPG 794 kb)
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Inokuchi, T., Sasaki, O., Nishioka, T. et al. Momentary and wide aortic regurgitation as an indicator of aortic dissection. Gen Thorac Cardiovasc Surg 65, 167–170 (2017). https://doi.org/10.1007/s11748-015-0595-y
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DOI: https://doi.org/10.1007/s11748-015-0595-y