Diagnosis of circumferential dissection of the ascending aorta by transesophageal echocardiography.

A 28-year-old woman with Marfan's syndrome presented with chest pain; transesophageal echocardiography showed circumferential dissection of the ascending aorta. Both aortic angiography with digital subtraction and computed tomography scanning with contrast were negative for dissection. Circumferential dissection of the ascending aorta was confirmed by surgery at which time replacement of the aorta and aortic valve were performed. Transesophageal echocardiography may become the most practical and reliable procedure for the diagnosis of aortic dissection.