Aortic dissection: intimal flap

Dissection separates layers of the aortic wall, creating channels divided by a flap. Ascending involvement defines Stanford type A.

Follow the aorta throughout the study and reconstructions. Assess entry tear, extent, branch involvement and complications; check motion artefacts.

A thin linear structure crosses the enhanced ascending aortic lumen at the arrow tip. The source identifies ascending aortic dissection.

Integrate acute pain, vascular examination and aortic history. Hypertension or known aortopathy may guide interpretation but cannot be inferred from the image.

Pulsation artefact may mimic a flap. Intramural haematoma and penetrating aortic ulcer are other acute aortic syndromes with distinct criteria.

Assess pulse asymmetry, neurological deficit and visceral malperfusion. Evaluate the aortic valve and pericardium with appropriate investigations.

Acute type A dissection requires immediate surgical assessment. Shock, tamponade and malperfusion are major complications to investigate.

Do not label true and false lumina from their apparent size on this slice alone. Absence of a complication in this field does not exclude it.

Identify the flap, establish ascending involvement and raise the alarm without delaying for a complete teaching exercise.

• ACC/AHA — Aortic disease guideline: key perspectives, part 2 (2022) ↗
• James Heilman, MD — document iconographique original / original image ↗

Documentary review: 2026-10-16