Dissecting aortic aneurysm--failure of standard noninvasive and invasive diagnostic techniques.

The diagnosis of cardiac tamponade due to dissection of an ascending aortic aneurysm in a middle-aged woman was not confirmed by the usual noninvasive and invasive procedures. The decision for surgery was based on clinical grounds only, resulting in an unnecessary delay of surgical intervention. Although some of the current noninvasive techniques seem to be most useful in the investigation of these patients, the clinical findings remain the cornerstone of a correct diagnosis.