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Point-of-care ultrasound in patients with aortic dissection – two year experience at Ljubljana Emergency Medical Unit


Aortic dissection (AD) is associated with high morbidity and mortality; mortality rates increase by 1-2% per hour1, therefore timely diagnosis is pivotal. Point-of-care ultrasound (PoCUS) narrows the number of differentials in patients with shock, chest pain and shortness of breath2; however, reports addressing its routine use in the ER are scarce.


Retrospective assessment of factors influencing use of PoCUS and its impact on time-to-diagnosis in patients with AD.

Patients and methods

We reviewed medical records and charts of patients with confirmed diagnosis of acute AD between May 2010 to May 2012.


Twenty-seven patients (out of 45.630 presenting to the ER) with AD were identified (19 type A, 8 type B; 13 with typical clinical presentation). Diagnosis was confirmed with contrast enhanced CT in 25 patients, and with PoCUS (during CPR) and autopsy in two. 14 (52%) had prior PoCUS (11 confirmed, 3 supported the diagnosis). PoCUS did not affect time-to-discharge from the ER significantly (87, 60-120 vs. 120, 102-240 minutes, p=0.179). PoCUS was performed more often in unstable patients (100 vs. 38.1% stable, p=0.09) and in patients with equivocal clinical presentation (30.8% vs. 71.4% in typical presentation, p=0.038). On a multivariate model, atypical clinical presentation emerged as an indenpedent predictor of PoCUS use after adjustment for age, gender, and hemodynamic stability (p=0.047).


Our findings suggest that point-of-care ultrasound is increasingly used in the initial ER management of patients with AD, especially in hemodynamically unstable patients and in patients with atypical clinical presentation.


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Correspondence to Hugon Možina.

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Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Možina, H., Jug, B. & Podbregar, M. Point-of-care ultrasound in patients with aortic dissection – two year experience at Ljubljana Emergency Medical Unit. Crit Ultrasound J 4 (Suppl 1), A14 (2012).

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