Is it a true dissection or intramural hematoma or penetrating ulcer

Look for thickness of the aortic wall, transducer to anterior aortic wall thickness, site of intimal tear, intimal flap, mobility of the flap, identify true and false lumen, morphology and flow characteristics of the false lumen, atherosclerotic debris, and/or ulcer crater.

• Is the dissection leaking? Look for pericardial effusion, distortion of the aortic and main pulmonary artery geometry, hazy echoes in the posterior trigone and transverse pericardial sinus. Increased flow velocity or color flow turbulence in the distal main pulmonary artery indicates compression of the vessel from hematoma.

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