Measure annulus, S of V, ST jx, ascending aorta in PLAX.
Aortic arch in suprasternal view.
Descending thoracic aorta in PLAX
Proximal abdominal aorta in subcostal.
The BSE figures for dilatation are based on S of V measurements and are defined by body surface area.
Referral for surgery varies slightly on the condition but in general it is about 5 cm regardless of level.
Hypertension and Marfans both cause effacement of ST jx.
The measurements in the table are not BSE ones (theirs are a range based on BSA which makes them impossible to learn). These will give you a pretty good idea for everyday scanning.
Aortic dissection
Better views with TOE, CT or MRI.
Majority (2/3) of dissections arise from ascending aorta – either 1st few cm or just distal to origin of L subclavian.
2D/M-mode
Look for
- Aortic dilatation.
- Dissection flap (linear mobile structure within the aorta which moves more than the aortic wall).
Colour
Flow in true and false lumens will be different and may be able to localise entry and exit points.
May be thrombus in false lumen (partial or no flow).
Complications of dissection seen on ECHO:
- AR
- LV RWMAs (involvement of coronary arteries causes ischaemia/infarction).
- Pericardial effusion/tamponade.