Acute Aortic Dissection is a medical emergency and often a difficult diagnosis to make. The classic presentation is tearing, mid-scapular pain, but because the aorta runs the length of the thorax and abdomen, dissection can present in various ways. I learned POCUS diagnosis of dissection as part of the RUSH exam, but that specifically looks at the abdominal aorta.
Arthur Broadstock, an EM PGY-3 at University of Cincinnati presents a great case over at Taming the SRU and looks at identifying Type A dissections with bedside POCUS. His case focuses on using the PLAX view of the heart to evaluate the aortic root. The suprasternal view of the aortic arch can also be quite useful and it’s probably the most under-taught view of the heart in terms of bedside echo.
For more on how to use that view, and lot more detail on the diagnosis of aortic dissection (Types A and B), see this nice post on POCUS 101.
critical care notes 