Abstract
Aortic echo plays an important role in the primary diagnosis and management of aortic dissection. The aorta can be assessed using the 4S approach (Superior-sternal view, Small-scale view, Sub-xiphoid view, Supra-sternal view). I have presented EASY and/or EASY plus screening for killer chest pain. The flap in overt dissection may resemble the symbol of Mazda (the car company). The flap in triple barrel dissection may resemble the symbol of Mercedes Benz, although the original report suggested the component of flap and aortic valve. Intramural hematoma is similar to mural thrombi and atheroma. Echographic lesions in intramural hematoma can present a smooth surface, crescent form, lucent echo density, and extensive area, which might be recalled as sclerosis. Thromboembolic acute arterial obstruction as a complication of aortic dissection might present as echographic lesions characterized as 4Ms: 1) Manifestation of the intima-media complex next to the adventitia. 2) Mild to moderate echolucency of the intravascular structure. 3) Mobility of the intravascular structure. 4) Pulsatile movement of the arterial wall.
