• Rui Guo, Yan-Mei Feng, and Dong Wan.
• Department of Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
• Medicine (Baltimore). 2017 Dec 1; 96 (49): e8773e8773.

RationaleAcute type A aortic dissection (AAAD) is a potentially fatal clinical crisis. Hemorrhagic cardiac tamponade due to the rupture of an ascending aortic root dissection is extremely dangerous and often lacks timely clinical evidence. We report sudden death in a patient diagnosed with AAAD and in whom critical care ultrasound highly indicated hemorrhagic cardiac tamponade.Presenting ConcernsA 75-year-old man was admitted to our emergency department with a complaint of chest pain for 8 hours. Computed tomography angiography findings indicated AAAD with a wide range of lesions. During the preoperative preparation process, he suddenly lost consciousness with a pulseless femoral artery.Diagnoses: Cardiopulmonary resuscitation was initiated and critical care ultrasound revealed hemorrhagic cardiac tamponade, strongly indicating the rupture of an ascending aortic root dissection.InterventionsHowever, family members refused further surgical interventions.OutcomesThe etiology could not be reversed and the patient died.LessonsCritical care ultrasound is an important skill that intensivists should master for fast screening of life-threatening complications in patients with AAAD.

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