Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report
Abstract Background Chest pain is a common reason patients are admitted to the hospital. The most clinically significant cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection (AAD). A prompt and correct diagnosis is crucial to patient su...
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BMC
2025-01-01
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| Series: | International Journal of Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12245-025-00811-9 |
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| author | Alicja Stankiewicz Beata Moczulska Wiktoria Izdebska Aleksandra Wińska Leszek Gromadziński |
| author_facet | Alicja Stankiewicz Beata Moczulska Wiktoria Izdebska Aleksandra Wińska Leszek Gromadziński |
| author_sort | Alicja Stankiewicz |
| collection | DOAJ |
| description | Abstract Background Chest pain is a common reason patients are admitted to the hospital. The most clinically significant cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection (AAD). A prompt and correct diagnosis is crucial to patient survival. This case report of a patient who presented with chest pain confirms the appropriateness of urgent imaging tests e.g. POCUS when AAD is suspected in high-risk patients, regardless of the results of additional laboratory tests such as the D-dimer (DD) assay. Case report A 72-year-old female patient was brought by the emergency medical team to the emergency room due to fainting without loss of consciousness and severe chest pain. Owing to worsening hypotonia and recurrent chest pain, a thoracic computed tomography (CT scan) was performed and subsequently revealed aortic dissection within the ascending segment with bleeding into the pericardial sac. The results of previously ordered laboratory tests, including the DD assay, were unremarkable and were obtained only after the thoracic CT scan had been acquired. Despite prompt medical intervention, the patient died. Conclusion Vigilance is required when diagnosing chest pain in high-risk patients who are suspected of having AAD. The case presented in this report confirms the importance of a thorough history and physical examination as well as prompt diagnostic imaging e.g. POCUS or CT scan. Dedicated laboratory tests such as the DD assay, while often helpful, may fail to reveal remarkable abnormalities in time for medical intervention. |
| format | Article |
| id | doaj-art-ac2bfdd358cb4bf98da2565fc75fa40b |
| institution | Kabale University |
| issn | 1865-1380 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj-art-ac2bfdd358cb4bf98da2565fc75fa40b2025-01-12T12:06:53ZengBMCInternational Journal of Emergency Medicine1865-13802025-01-011811610.1186/s12245-025-00811-9Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case reportAlicja Stankiewicz0Beata Moczulska1Wiktoria Izdebska2Aleksandra Wińska3Leszek Gromadziński4Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and MazuryDepartment of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and MazuryDepartment of Gastroenterology and Internal Medicine, Medical University of BialystokEmergency Room, University Clinical Hospital in OlsztynDepartment of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and MazuryAbstract Background Chest pain is a common reason patients are admitted to the hospital. The most clinically significant cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection (AAD). A prompt and correct diagnosis is crucial to patient survival. This case report of a patient who presented with chest pain confirms the appropriateness of urgent imaging tests e.g. POCUS when AAD is suspected in high-risk patients, regardless of the results of additional laboratory tests such as the D-dimer (DD) assay. Case report A 72-year-old female patient was brought by the emergency medical team to the emergency room due to fainting without loss of consciousness and severe chest pain. Owing to worsening hypotonia and recurrent chest pain, a thoracic computed tomography (CT scan) was performed and subsequently revealed aortic dissection within the ascending segment with bleeding into the pericardial sac. The results of previously ordered laboratory tests, including the DD assay, were unremarkable and were obtained only after the thoracic CT scan had been acquired. Despite prompt medical intervention, the patient died. Conclusion Vigilance is required when diagnosing chest pain in high-risk patients who are suspected of having AAD. The case presented in this report confirms the importance of a thorough history and physical examination as well as prompt diagnostic imaging e.g. POCUS or CT scan. Dedicated laboratory tests such as the DD assay, while often helpful, may fail to reveal remarkable abnormalities in time for medical intervention.https://doi.org/10.1186/s12245-025-00811-9D-dimerThoracic Aorta DissectionChest Pains |
| spellingShingle | Alicja Stankiewicz Beata Moczulska Wiktoria Izdebska Aleksandra Wińska Leszek Gromadziński Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report International Journal of Emergency Medicine D-dimer Thoracic Aorta Dissection Chest Pains |
| title | Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report |
| title_full | Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report |
| title_fullStr | Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report |
| title_full_unstemmed | Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report |
| title_short | Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report |
| title_sort | acute aortic dissection on ct is d dimer determination useful for a timely and correct diagnosis a case report |
| topic | D-dimer Thoracic Aorta Dissection Chest Pains |
| url | https://doi.org/10.1186/s12245-025-00811-9 |
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