In four patients, echocardiography showed duplication of an aortic wall echo. An aortic dissection was present in only one. Other causes for the echocardiographic pattern were abscess in the interventricular septum, mitral stenosis, and dilatation of the noncoronary sinus of Valsalva. Division of the echo from the mitral ring into two separate posterior aortic wall echoes was seen only in the patient with dissecting aneurysm; it is suggested that this appearance adds to the specificity of the finding of aortic wall duplication by echocardiography in the diagnosis of aortic dissection.
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