The Echocardiographic “Spike and Dome” – Obstruction It Is But Where?

Spectral D oppler interrogation of the descending thoracic and abdominal aorta provides valuable information regarding cardiac and vascular hemodynamics. An abnormal aortic D oppler profile is encountered in pathological conditions that affect the aorta and its branches, the aortic valve, the left ventricle, and the pericardium. Characteristic findings on D oppler interrogation of the aorta are often noted in individuals with obstructive atherosclerotic disease of the aorto‐iliac system including severe stenosis or occlusion of the distal aorta and/or iliac arteries. In this manuscript, we highlight the findings on spectral D oppler that led to the identification of occlusive disease in the distal aorta.