case_images: PMC6587712_01
case_images: Contrast-enhanced computed tomography shows aortic dissection with a partially thrombosed false lumen in the descending aorta and an intimal flap extending from the descending thoracic aorta to the right common iliac artery. Center: Image obtained by 3-dimensional reconstruction of computed tomography data. Left and Right: Early phase axial images. Note that there is no evidence of obstruction or severe compression of the true lumen by the false lumen. AA, Ascending aorta; DA, Descending aorta; FL, False lumen; IF, Intimal flap; L, Left; R, Right; TL, True lumen
case_images: ECHO-36-189-g001.jpg
case_images: PMC6587712_01_ECHO-36-189-g001.jpg
case_images: echo14198-fig-0001
case_images: Contrast-enhanced CT again demonstrated no evidence of obstruction or severe narrowing of the true lumen (Figure 1).
case_images: Doppler US shows exercise-induced changes of the Doppler velocity waveform in the left common femoral artery (CFA). A, Doppler US shows bisferious velocity waveforms with dampened early and late systolic components (red and yellow arrows) and absent diastolic component immediately after walking. B, Ten minutes later, Doppler US shows normal Doppler velocity waveforms after complete resolution of his symptoms. L-CFA, Left common femoral artery, L-CFV, Left common femoral vein
case_images: ECHO-36-189-g002.jpg
case_images: PMC6587712_01_ECHO-36-189-g002.jpg
case_images: echo14198-fig-0002
case_images: Under these conditions, Doppler ultrasound (US) of the left common femoral artery, which was supplied via true lumen, showed a bisferious velocity waveform with dampened early and late systolic components and absent diastolic components (Figure 2A, red and yellow arrows). Ten minutes later, repeat Doppler US of the left common femoral artery showed a normal waveform after complete resolution of his symptoms with a blood pressure of 108/54 mm Hg (Figure 2B).