Rapid bedside multimodal ultrasound screening for acute type A aortic dissection: a perspective

Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency where delays in diagnosis worsen outcomes. While computed tomography angiography remains the diagnostic gold standard, its requirement for patient transport, contrast administration, and radiation exposure limits its utility in urgent scenarios. Multimodal point-of-care ultrasound (PoCUS) presents a viable bedside alternative by combining transthoracic echocardiography, vascular ultrasound, and, when available, transesophageal echocardiography. This integrated approach facilitates a rapid, comprehensive assessment, allowing for the detection of key findings—such as pericardial effusion, aortic root dilation, and an intimal flap—within minutes. PoCUS can shorten the time from clinical suspicion to treatment decision, avoid the risks associated with transporting unstable patients, and assist in differentiating other causes of acute chest pain. This perspective article scrutinizes the role of multimodal PoCUS in screening for ATAAD, addresses its technical and training limitations, and explores future directions, including integration with artificial intelligence, standardized training protocols, and optimized clinical workflows. The goal is to inform the development of more efficient, timely diagnostic strategies for this critical condition.