In this case a sudden deterioration in the emergency department prompts a TTE which shows some concerning physiology.  It is not until the TEE is inserted, however, that the culprit disease can be identified.

*Images courtesy of Dr. Drew Thompson, Division of EM, Western University

Case Highlights:

*TEE in the ED is valuable for critically ill patients

*TEE has advanced diagnostic potential, including the identification of aortic dissection in a rare number of cases

*TEE has value in cardiac arrest in particular for its ability to provide all the benefits of echocardiography (identification of reversible causes, prognostication, subjective and objective evaluation of CPR quality) without any need to interrupt chest compressions