Miscellaneous

Although not commonly encountered in daily clinical practice, with the exception of atheromatous disease in the older population, disorders of the thoracic aorta often present dramatically and require urgent evaluation. Echocardiography is ideally suited for this purpose, particularly in the critical care setting where both transthoracic echocardiogram (TTE) and transoesophageal echocardiography (TOE) can play important roles in the bedside diagnosis and management of afflicted patients. An understanding of the anatomical relationships of the aorta within the thoracic cavity is important, in addition to specific pertinent findings within each of the different pathologies. The physician should be on the alert for complications following acute myocardial infarction and echocardiography is central to the majority of diagnoses. A baseline echo for all critically ill patients who have suffered an infarction is recommended. Constrictive pericarditis, when encountered is usually unexpected, and can be life-threatening if not diagnosed quickly in the critical care setting. As such, the physician needs to know certain echocardiographic features that assist in the diagnosis.