Traumatic hemomediastinum on TEE

This TEE longitudinal view demonstrates a traumatic subadventitial rupture of the aortic isthmus complicated by a pseudocoarctation syndrome. The disrupted wall resulted in a significant reduction of the aortic lumen with hemodynamically significant obstruction (A, arrow), which induced marked blood flow turbulence, as reflected by the narrow color Doppler flow signal with aliasing despite high Nyquist limits (B, arrowheads).