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Letter: Dissecting aortic aneurysm diagnosed by echocardiography.

I would like to comment on a recent article in the British Heart journal (I974) 36, III, by Yuste, Aza, Minguez, Cerezo, and Martinez-Bordin. Echocardiography has been useful in diagnosing dissecting aortic aneurysms; though our experience at this time is extremely limited. Normally the walls of the aorta move in a parallel manner, and in aortic root dissection this parallelism between the separated walls is maintained. In Fig. 2a, the anterior wall (AW) is not moving parallel to die posterior wall (PW). The separated walls are out of phase. Normally when the aortic valve opens both walls of the aorta start to move anteriorly and continue to do so for a while after the aortic valve closes. The structure labelled AW moves in this pattern. However, the structure labelled PW moves posteriorly during ventricular systole and does not have the motion pattern of the aortic wall. This may represent a large pericardial effusion due to fluid in the transverse sinus of the pericardium or may be an obscure non-parallel linear echo in the left atrial cavity. In any case, a false lumen may be present anteriorly but has not been demonstrated satisfactorily posteriorly.