Update on Cardiovascular Echo in Aortic Aneurysm and Dissection

Abstract

The majority of aortic aneurysms comorbid with atherosclerosis can be asymptomatic and are discovered incidentally on routine physical examination or on imaging studies for other indications. Transthoracic echocardiography is a basic modality to assess patients with coronary artery disease and can be used for the screening of aortic aneurysm. Acute aortic dissection is a highly lethal cardiovascular emergency and requires prompt recognition. Although cardiovascular echo has a suboptimal accuracy rate for detecting aortic dissection, it is noninvasive, readily available, and easy to use. Recently, the concept of point-of-care ultrasound (POCUS) refers to the use of portable ultrasound at the patient's bedside for diagnostic and therapeutic purposes. POCUS could become an important tool in the screening and primary diagnosis for acute aortic dissection. Transesophageal echocardiography (TEE) was established to detect aortic dissection and determine the therapy. However, the use of TEE has decreased with the progress of contrast-enhanced computed tomography. Currently, attention is paid to TEE in the monitoring for the operation of aortic dissection, the use on bedside, and in emergency room, and the precise evaluation of aortic dissection for the patient with a history of allergy of contrast media and/or renal disturbance.