Utility of two-dimensional echocardiography in suspected ascending XXXX .

@entity1 @entity662 @entity1580
The value of 2-dimensional echocardiography (2-D echo) in @entity1 with suspected ascending @entity1580 was assessed. During a 5.5-year period, 56 consecutive @entity1 underwent bedside 2-D echo for unexplained @entity662 possibly due to ascending @entity1580 . @entity1 with obvious @entity1580 who proceeded directly to aortography were excluded and in all 56 study cases, 2-D echo was the initial diagnostic test. Using standard criteria, 2-D echo correctly identified all 13 @entity1 with ascending @entity1580 . There were 5 false-positive study results and 38 true-negative results, yielding a sensitivity of 100%, specificity of 88% and overall diagnostic accuracy of 91%. In the group of 13 @entity1 with confirmed ascending @entity1580 , 2-D echo identified 4 with pericardial fluid, and 3 of these @entity1 (75%) died within 24 hours. In comparison, 7 @entity1 in the group of 43 without confirmed dissection had pericardial fluid by 2-D echo and only 1 died (p less than 0.001). Finally, in the group of 38 @entity1 with true-negative results, 2-D echo provided useful information in 16 (42%) that assisted or was essential in establishing an alternative diagnosis. However, 5 @entity1 in this group had type III dissection and in none was it identified by 2-D echo. Thus, our data indicate that 2-D echo represents a reliable noninvasive method for rapidly diagnosing ascending @entity1580 at the bedside; offers important prognostic information which is directly related to the presence of pericardial fluid, and provides useful additional information which assists or establishes an alternative diagnosis when ascending @entity1580 is absent.(ABSTRACT TRUNCATED AT 250 WORDS)
