Progression of aortic root dissection and cardiac tamponade. Documented by sequential echocardiographic examinations

The M-mode echocardiographic features of aortic root dissection and its progression to cardiac tamponade in a 68-year-old white man are reported. The diagnosis was confirmed both by angiography and by autopsy. Negative and positive echocardiographic patterns could be obtained at the time of the first clinical diagnosis with slight different angulations of the transducer. Progression of the dissection and evidence of increase of pericardial fluid to cardiac tamponade could then be documented by sequential echocardiograms. M-mode echocardiography is a useful tool in the recognition of aortic dissection. Prolonged and accurate searching of the dissected area is required before a negative echocardiogram is accepted. Multiple sequential echocardiograms must be obtained to eventually detect a progression of the dissection or an increase in pericardial fluid. The possibility to follow the evolution of the disease may be extremely important in the choice of therapeutic intervention.