A Case Report of Three Dimensional Transthoracic Echocardiographic View of Acute Proximal Type Aortic Dissection

A 67 year-old female patient was admitted to our emergency room with the complaint of severe and sudden onset tearing like chest pain lasting for an hour. Immediately performing two-dimensional transthoracic echocardiography (2DTTE), pericardial effusion and an undulating intimal flap within the aortic lumen starting from the non-coronary cuspid were visualized. Ascending aorta was 7.6 cm in diameter. Real-time three-dimensional (RT 3D) TTE confirmed the diagnosis. Once the diagnosis of acute proximal type aortic dissection is suspected which modality to be chosen depends on clinical status of the patient and technical availability of the hospital. Non-invasive diagnostic modalities like contrast enhanced computed tomography (CECT), magnetic resonance imaging (MRI) may be preferred over invasive aortography. As transesophageal echocardiography (TEE) is a semi-invasive procedure and is mostly used intraoperatively, TTE may be preferred instead of TEE. RT 3DTTE is a helpful equipment in confirming the diagnosis of aortic dissection by 2DTTE. RT 3DTTE is advantageous in terms of accessibility and applicability at bedside and being a non-invasive procedure.