Disease of the Aorta

  • Azin Alizadehasl
  • Anita Sadeghpour


Echocardiography plays an essential role in the diagnosis, management plans, and follow-up of aortic diseases. Study of the aorta is a routine part of the standard echocardiographic examination. Transthoracic echocardiography (TTE) permits adequate assessment of several aortic segments, mainly the aortic root and the proximal ascending aorta. Transesophageal echocardiography (TEE) overcomes the limitations of TTE in the evaluation of the thoracic aorta. TEE must be used in a complementary manner. Echocardiography is useful and valuable for assessing the size, biophysical properties, and atherosclerotic involvement of the thoracic aorta. Although TEE is a useful method in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in the proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. Nonetheless, a negative TTE does not rule out aortic dissection and other imaging modalities should be considered. TEE must define entry tear location, mechanisms and severity of aortic regurgitation, and also true lumen compression. Additionally, echocardiography is crucial in selecting and monitoring surgical and endovascular treatment and in noticing possible complications. Even though other imaging techniques such as computed tomography and magnetic resonance imaging have a greater field of view and can yield complementary information, echocardiography is accurate, portable, rapid, and cost-effective in the diagnosis, management plans, and follow-up of most aortic diseases.


Aortic diseases Transesophageal echocardiography Transthoracic echocardiography Aneurysm of aorta Aortic dissection Intramural hematoma (IMH) Coarctation (COA) Pseudoaneurysms 



Aortic valve


Body surface area




Computed tomography


Intramural hematoma


Magnetic resonance imaging


Sinotubular junction


Transesophageal echocardiography


Transthoracic echocardiography

Supplementary material

Movie 38.1

Mobile dissecting flap obviously is visible in transthoracic echocardiography in systole and diastole that interfere with Aortic valve closure resulting sever aortic regurgitation in long axis and short axis view of transthoracic echocardiography (AVI 5123 kb)

Movie 38.2

Mobile dissecting flap obviously is visible in transthoracic echocardiography in systole and diastole that interfere with Aortic valve closure resulting sever aortic regurgitation in long axis and short axis view of transthoracic echocardiography (AVI 1436 kb)

Movie 38.3

Left thin, mobile linear echogenicity in the artic root with interference with Aortic valve suggesting for acute type A acute aortic dissection (AVI 4912 kb)

Movie 38.4

Left thin, mobile linear echogenicity in the artic root with interference with Aortic valve suggesting for acute type A acute aortic dissection (AVI 4900 kb)

Movie 38.5

Thick and fixed linear echogenicity associated with aneurysmal dilatation of aortic root in a Marfan syndrome (AVI 21858 kb)

Movie 38.6

Intramural hematoma in short axis and long axis of the descending thoracic aorta (AVI 5699 kb)

Movie 38.7

Complex atherosclerotic plaque of descending thoracic aorta (AVI 8392 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Azin Alizadehasl
    • 1
  • Anita Sadeghpour
    • 2
  1. 1.Associate Professor of Cardiology, Echocardiologist, Echocardiography and Cardiogenetic Research CentersCardio-Oncology Department, Rajaie Cardiovascular Medical and Research CenterTehranIran
  2. 2.Professor of CardiologyEchocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical ScienceTehranIran

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