Fig. 3

a-d Computed tomography (CT) angiography and e transthoracic and f-g transesophageal echocardiography (TEE) scans; a-b Aorta CT angiography, axial plane. a The site of entry tear is suspected to be located in the proximal brachiocephalic artery (white arrow) but a dissection flap cannot be clearly observed; b This aortic dissection (AD) mimics an intramural hematoma (IMH) retrogradely extending to the sinuses of Valsalva resulting in pericardial effusion; c Three-dimensional reconstructed image and d Sagittal oblique reconstruction image of aorta CT angiography shows the extent of AD mimicking an IMH extending anterogradely to the proximal descending thoracic aorta; e subcostal view of transthoracic echocardiogram reveals newly developed, moderate amount of pericardial effusion; f TEE (135 degree long axis view) showed no definite dissection flap and intramural hematoma in the aortic root. g TEE (0 degree short axis view) revealed an IMH extending anterogradely to the proximal descending thoracic aorta