DISSECTED AORTA, SONOGR. Dissection of the aorta at the start of the aorta caused by a hematoma _ Cardiac ultrasound. The dissecting aneurysm, or aortic dissection, is a longitudinal tear of the aorta wall. This tear can be provoked, as here, by a hematoma dissecting or intramural hematoma, separating the tunica intima internal layer of the adventitia external layer of the arterial wall. This hematoma leads to medianecrosis, progressive destruction of the media intermediary layer of the wall, an