The use of echocardiographic contrast-enhanced rapid diagnosis of ruptured aortic dissection with transthoracic echocardiography.

Aortic dissection is an uncommon but often fatal condition if not promptly managed. Although the diagnosis is generally established by transesophageal echocardiography, contrast computed tomography, or magnetic resonance imaging, clinical and radiologic assessment and transthoracic echocardiography represent the first-line approach to patients with sudden onset of severe tearing thoracic pain. Although surface image quality and spatial resolution may prevent detection of an intimal flap, the presence of aortic dilatation, aortic regurgitation, segmental ventricular dysfunction, and effusions indicate a greater likelihood of a lethal outcome and hasten urgent management. Because an aortic rupture may be the cause of an effusion, rapid diagnosis is crucial. We report an unusual case of Stanford type B aortic dissection with rupture that was diagnosed by transthoracic echocardiography and confirmed with an ultrasound contrast injection.