Rapid bedside multimodal ultrasound screening for acute type A aortic dissection: a perspective

Area of Science:

• Cardiovascular Medicine
• Diagnostic Imaging
• Emergency Medicine

Background:

• Acute type A aortic dissection (ATAAD) is a critical emergency with delayed diagnosis worsening outcomes.
• Computed tomography angiography (CTA) is the gold standard but has limitations in urgent settings due to transport, contrast, and radiation.
• Rapid diagnosis is crucial for timely intervention in ATAAD.

Purpose of the Study:

• To evaluate the role of multimodal point-of-care ultrasound (PoCUS) as a rapid screening tool for ATAAD.
• To highlight PoCUS's advantages over traditional imaging in emergency scenarios.
• To discuss limitations and future directions for PoCUS in ATAAD diagnosis.

Main Methods:

• Utilizing a multimodal point-of-care ultrasound (PoCUS) approach, integrating transthoracic echocardiography, vascular ultrasound, and transesophageal echocardiography.
• Assessing PoCUS for rapid, bedside detection of key ATAAD findings like pericardial effusion, aortic root dilation, and intimal flaps.
• Comparing PoCUS utility against standard diagnostic methods in urgent settings.

Main Results:

• Multimodal PoCUS enables rapid, comprehensive bedside assessment for ATAAD within minutes.
• PoCUS facilitates early detection of critical diagnostic markers for ATAAD.
• The approach can potentially reduce diagnostic delays and avoid risks of patient transport.

Conclusions:

• Multimodal PoCUS serves as a valuable bedside screening tool for ATAAD, complementing traditional imaging.
• Addressing technical and training limitations is essential for widespread PoCUS adoption in ATAAD diagnosis.
• Future integration with AI and standardized protocols can optimize PoCUS workflows for critical cardiovascular emergencies.