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[Identification of intramural aortic hematoma by transesophageal echocardiography]
I Vilacosta1, J Antonio Castillo, J Alberto San Román
1Servicio de Cardiología, Hospital Universitario de San Carlos, Madrid.
Insights
Transesophageal echocardiography can detect intramural aortic hematoma, a rare aortic dissection variant. This imaging technique aids in diagnosis and follow-up when other methods may fail.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Transesophageal echocardiography (TEE) is established for diagnosing aortic dissection.
- Intramural aortic hematoma (IMH) is a less common form of aortic dissection.
Purpose of the Study:
- To assess the utility of TEE in detecting IMH.
- To evaluate TEE's role in monitoring patients with IMH.
Main Methods:
- Retrospective review of 51 patients with aortic dissection diagnosed via TEE.
- Analysis of diagnostic accuracy and follow-up data.
Main Results:
- TEE identified IMH in 6 patients (11%).
- Diagnosis was confirmed through anatomical correlation, advanced imaging (CT/MRI), or TEE follow-up.
Conclusions:
- IMH is an infrequent variant of aortic dissection.
- TEE can detect IMH, often missed by conventional aortography.
Background And Aim:
The usefulness of transesophageal echocardiography in the diagnosis and assessment of patients with aortic dissection has been widely demonstrated. The aim of this study was to evaluate the role of this technique in the detection of intramural aortic hematoma and in the follow-up of these patients.
Methods:
The records of 51 patients with aortic dissection by transesophageal echocardiography diagnosed between May 1990 and May 1994 were reviewed.
Results:
The diagnosis of intramural aortic hematoma was established in 6 patients by transesophageal echocardiography (11%). This diagnosis was confirmed either anatomically (3 patients) or with an additional diagnostic technique (computed tomography or magnetic resonance imaging) and on the basis of echocardiographic follow-up changes (3 patients).
Conclusions:
Intramural aortic hematoma represents an infrequent variant of aortic dissection that can be detected by transesophageal echocardiography and is usually unrecognized by aortography.