Aortic Dissection as a Cause of Pulsus Bisferiens: A Case Report and Review

We present a case of a 62-year-old woman who developed an aortic dissection after aortic valve replacement for aortic stenosis and supracoronary replacement of the ascending aorta for aneurysmal dilation. Dynamic compression of the distal aorta by the dissection flap was identified with the detection of abnormal continuous wave Doppler signals heard while performing ankle-brachial indices. Duplex ultrasound (US) and Doppler spectral waveforms confirmed dynamic compression of the distal aorta with each cardiac cycle. We review some of the characteristics of continuous wave Doppler signals, specifically discussing the distinguishing characteristics of pulsus bisferiens, and the use of duplex US in imaging the distal aorta.