Detection of Type B Aortic Dissection in the Emergency Department with Point-of-Care Ultrasound

• Main Authors: Emily Earl-Royal, Phi D. Nguyen, Al’ai Alvarez, Laleh Gharahbaghian
• Format: Article
• Language: English
• Published: eScholarship Publishing, University of California 2019-08-01
• Series: Clinical Practice and Cases in Emergency Medicine
• Online Access: https://escholarship.org/uc/item/7jf15054

Aortic dissection (AD) is a rare, time-sensitive, and potentially fatal condition that can present with subtle signs requiring timely diagnosis and intervention. Although definitive diagnosis is most accurately made through computed tomography angiography, this can be a time-consuming study and the patient may be unstable, thus preventing the study’s completion. Chest radiography (CXR) signs of AD are classically taught yet have poor diagnostic reliability. Point-of-care ultrasound (POCUS) is increasingly used by emergency physicians for the rapid diagnosis of emergent conditions, with multiple case reports illustrating the sonographic signs of AD. We present a case of Stanford type B AD diagnosed by POCUS in the emergency department in a patient with vague symptoms, normal CXR, and without aorta dilation. A subsequent review of CXR versus sonographic signs of AD is described.