Diagnosis
Diagnosis Challenges
Diagnosing an aortic dissection is sometimes difficult because its symptoms mimic those of a wide range of other health issues including a heart attack or pulmonary embolism.
Aortic dissection is often suspected if you experience the sudden onset of tearing or ripping pain in the chest, show a widening of the aorta on chest x-ray or if your blood pressure is different from one extremity to the other.
Even if one or more symptoms are present, more detailed imaging tests are needed to make a definitive diagnosis.
Unfortunately, in many cases, aortic dissection does not get diagnosed until you are in the emergency room following a sudden, catastrophic event. Half of all patients die before reaching the hospital.
Diagnostic Tests
If the condition is diagnosed early, or you are being treated in the emergency room, the following tests may be performed.
Chest x-ray
This simple test uses radiation to take pictures of structures inside the body.
Echocardiogram
This test uses high frequency sound waves or ultrasound to examine the size, shape and motion of the heart as well as the structure of the aorta.
Computerized Tomography (CT) Scan
This is a type of x-ray that uses a computer to make cross-sectional images of structures inside the body. To diagnose aortic dissection, a CT scan of the chest is taken. A contrast dye is typically injected into the blood to make arteries more visible on the pictures.
Magnetic Resonance Imaging (MRI) Scan
This is a test that uses a magnetic field and radio waves to take images of inside the body. In the case of suspected aortic dissection, the test is called a magnetic resonance angiogram (MRA), and it is designed specifically to look at blood vessels. The MRA is of the chest area. The test also uses a contrast dye to make the images more visible.
Transesophageal Echocardiography (TEE)
This test uses sound waves to make an image of the heart. A TEE is a special type of echocardiogram -- a common test used to detect heart disease -- where an ultrasound device is placed down the esophagus, close to the heart and aorta. It makes clearer pictures than does a conventional echocardiogram and is an excellent test for a dissection.