Aortic dissection

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Tests and diagnosis

By Mayo Clinic staff

Detecting an aortic dissection can be tricky because the symptoms are similar to those of a variety of health problems. Doctors often suspect an aortic dissection if the following signs and symptoms are present:

  • Sudden tearing or ripping chest pain
  • Widening of the aorta on chest X-ray
  • Blood pressure difference between right and left arms

Although these signs and symptoms suggest aortic dissection, more-sensitive imaging techniques are usually needed. The most frequently used imaging procedures include:

  • Computerized tomography (CT) scan. CT scanning uses a machine that generates X-rays to produce cross-sectional images of the body. In order to diagnose an aortic dissection, a CT scan of the chest is taken. A contrast liquid that contains iodine may be injected into the blood during a CT scan. Contrast makes the heart, aorta and other blood vessels more visible on the CT pictures.
  • Magnetic resonance angiogram (MRA). A magnetic resonance imaging (MRI) scan is a test that uses a magnetic field and pulses of radio wave energy to make pictures of the body. MRA refers to the use of this technique specifically to look at blood vessels. An MRA of the chest can be used to diagnose aortic dissection.
  • Transesophageal echocardiogram (TEE). An echocardiogram is a type of test that uses high-pitched sound waves to produce an image of the heart. A TEE is a special type of echocardiogram in which an ultrasound probe is inserted through the esophagus. Since the ultrasound probe is placed close to the heart and the aorta, it provides a clearer picture of your heart and its structures than would a regular echocardiogram.
References
  1. Braverman AC, et al. Diseases of the aorta. In: Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Sept. 15, 2011.
  2. Ankel F. Aortic dissection. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Sept. 15, 2011.
  3. Manning WJ. Clinical manifestations and diagnosis of aortic dissection. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
  4. Manning WJ. Management of aortic dissection. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
  5. Prevention: What you can do. Centers for Disease Control and Prevention. http://www.cdc.gov/heartdisease/what_you_can_do.htm. Accessed Sept. 15, 2011.
  6. Loeys-Dietz syndrome. Johns Hopkins Medicine. http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/conditions/loeys_dietz.html. Accessed Oct. 4, 2011.
DS00605 Nov. 11, 2011

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