Transthoracic echocardiography may show dissection of the aortic root, aortic regurgitation, and the presence of blood in the pericardium. Other findings supportive of a diagnosis of ascending aortic dissection include dilation or thickening of the aortic root and an absence of left ventricular dysfunction or regional wall motion abnormalities. Its major advantages are speed, non-invasion, and non-interference with treatment and monitoring. It has no value in the assessment of descending aortic dissections.

Transesophageal echocardiography is becoming the investigation of choice in unstable patients ( Tieasure.and.RaphaeJ 1991) as it can be carried out at the bedside or in the operating theatre. It will usually allow accurate assessment of the origin of the dissection, its distal extent, and the state of the aortic valve.

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