BCEN CEN Practice Question

Computed tomography (CT) angiography is the preferred initial imaging study in hemodynamically stable patients with suspected aortic dissection because it is rapid, widely available, and has sensitivity and specificity greater than 95 % for detecting an intimal flap. Transthoracic echocardiography (TTE) may miss distal dissections, and transesophageal echo, while highly accurate, is semi-invasive and less readily available. A chest X-ray can show mediastinal widening or other indirect signs but neither rules in nor rules out dissection. An electrocardiogram helps assess for concurrent ischemia or left-ventricular hypertrophy but is not diagnostic for dissection.