Localized aortic dissection: Unusual features by transesophageal echocardiography

Transesophageal echocardiography relies on the presence of an undulating in timal flap for the diagnosis of aortic dissection. Furthermore, to distingu ish true dissection from echo artifacts, the flap has to be identified in m ore than one view, and it must have a motion independent of the aortic mall . We describe the transesophageal echocardiography appearance of a localize d aortic dissection with atypical features for an intimal flap. Awareness o f this unusual echocardiographic appearance of an intimal flap will avoid m isdiagnosis of the potentially serious acute aortic dissection.