Traumatic Rupture of Atherosclerotic Plaque Producing Aortic Isthmus Dissection

Traumatic rupture of aortic isthmus atherosclerotic plaque resulting in dissection has not been documented through the use of either invasive or noninvasive diagnostic modalities. We describe an elderly patient in whom transesophageal echocardiography and three-dimensional reconstruction of multiplane transesophageal two-dimensional images clearly demonstrated the traumatic dissection to be due to rupture of a large atherosclerotic plaque located in the aortic isthmus. The patient had experienced blunt trauma to the chest from the impact of the steering wheel during an automobile accident.