TORTUOSITY OF THE DESCENDING THORACIC AORTA SIMULATING DISSECTION ON TRANSESOPHAGEAL ECHOCARDIOGRAPHY

In an 80-year-old patient with syncope, a markedly tortuous descending thoracic aorta produced images on transesophageal echocardiography wh ich were suggestive of an intimal flap caused by dissection. A magneti c resonance aortogram clearly showed that the transesophageal echocard iogram was a false positive. In addition, multiplanar reconstructed im ages of the magnetic resonance aortogram through the tortuous descendi ng thoracic aorta could reproduce images similar to that seen by trans esophageal echocardiography. Because transesophageal echocardiography has become a popular imaging modality for the detection of aortic diss ection, it is essential for echocardiographers to be aware of possible pitfalls which may create false positive findings.