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Updated: Dec 30, 2025

Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case
Kushani Gajjar1, Robert Biederman1
1Department of Cardiology, Allegheny General Hospital, Pittsburgh, PA.
Abstract:
A 30-year-old female patient with past medical history of supraventricular tachycardia presented with shortness of breath and underwent a transthoracic echocardiogram (TTE). The TTE noted a concerning partially mobile linear echo density, with positive Doppler color flow across it along the aortic arch, which was concerning for a dissection flap. The patient accordingly underwent a cardiac MRI which revealed that the anomaly seen on echocardiogram was in the setting of a prominent left brachiocephalic (innominate) vein and without evidence of aortic dissection. While this is a relatively common phenomenon, there is no literature on prominent brachiocephalic vein masquerading as an aortic dissection flap on TTE.
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