Thoracic Aortic Emergencies on Ultrasound: Recognizing Aneurysms and Dissections

Thoracic and abdominal aortic pathologies, including aneurysms and dissections, require rapid bedside ultrasound diagnosis to significantly improve patient outcomes. Aortic size thresholds for intervention vary by location, necessitating specific measurement techniques such as leading-edge to leading-edge assessment. Clinicians can utilize parasternal and suprasternal views to identify intimal flaps, aortic regurgitation, and pericardial effusions—the latter being a leading cause of death in dissections. While computed tomography remains the gold standard for surgical planning, bedside ultrasound provides critical diagnostic speed in acute settings. Secondary signs like diastolic collapse of the right ventricle help identify tamponade, while understanding anatomical landmarks and patient-specific variables, such as body surface area, ensures accurate evaluation. These diagnostic capabilities allow for immediate intervention or stabilization before formal imaging or surgical consultation, effectively lowering the threshold for identifying life-threatening vascular conditions.