Continuous Döppler and aortic dissection. Apropos of 2 cases of protosystolic Döppler velocity wave anomalies in type I aortic dissections
Dany, F.; Delhoume, B.; Bensaid, J.; Virot, P.; Blanc, P.; Doumeix, J.J.; Kim, M.; Guilmet, D.
Archives des Maladies du Coeur et des Vaisseaux 76(1): 45-51
1983
ISSN/ISBN: 0003-9683 PMID: 6405714 Document Number: 216299
The diagnosis of dissection of the aorta is based on clinical examination, echocardiography and angiography of the aortic arch. Continuous Döppler ultrasonography may also be useful as a very suggestive abnormality of the wave form can be recorded from the dissected vessels, comprising a deep early mid systolic notch which gives the wave a double hump appearance. This phenomenon, observed in two type I dissections, was recorded from the right subclavian and vertebral arteries in the first case in which the initial components of the systolic wave of the right carotid artery were also amputated. In the second case, the phenomenon was recorded from all vessels arising from the aortic arch. The underlying mechanism could be herniation of the false into the true arterial lumen leading to temporary obstruction of systolic ejection. Another possibility is the successive recording of blood flow first in the true and then in the false lumen. Midsystolic Döppler abnormalities have also been described in aortic regurgitation, hypertrophic obstructive cardiomyopathy, atheromatous plaques causing a valve effect; however, the timing, morphology and extension of these abnormalities are quite different. In practice, the finding of this abnormality is an additional argument in favour of the diagnosis of dissection of the aorta. Continuous Döppler ultrasonography is also a good method of assessing the peripheral consequences of the dissection.