Aortic dissection: A "humerus" case.

Abstract

Aortic dissection usually presents with acute onset of severe chest pain. Classically there is a pressure differential between the 2 arms and widening of the mediastinum. Echocardiography is considered the investigation of choice in many institutions. A case is presented in which the presentation and clinical signs are classical for dissection. Transthoracic echocardiography demonstrated "enlargement" of the descending aorta and a "flap." A surprise diagnosis was made by transesophageal echocardiography. Other vascular structures in the para-aortic regions should be considered when the diagnosis of aortic dissection is entertained.