Echocardiogram in a Woman with Postpartum Dyspnea and Severe Aortic Regurgitation

A 38-year-old woman developed worsening dyspnea, a new heart murmur, and an elevated brain-type natriuretic peptide level greater than 800 pg/mL (to convert to nanograms per liter, multiply by 1) 1 week post partum. A transthoracic echocardiogram showed a normal-sized left ventricle and preserved left ventricular ejection fraction, severe aortic regurgitation, and a mildly dilated aortic root. The short-axis view in this video shows echogenic tissue in the aortic sinus, which was confirmed on transesophageal echocardiography to be the intimal flap of a type A aortic dissection, with limited extension beyond the aortic root. She underwent surgical repair; results of genetic testing was negative for connective tissue disorders. Click the Related Article link for complete case details.