Key result
High D-dimer levels prompted a bedside ultrasound that rapidly identified a dilated aortic root and pericardial tamponade, leading to the diagnosis of acute aortic dissection.
Why the study?
Does a D-dimer test help make the diagnosis of aortic dissection in a patient presenting with vague abdominal discomfort and syncope?
Case Report (n=1)
Does a D-dimer test help make the diagnosis of aortic dissection in a patient presenting with vague abdominal discomfort and syncope?
High D-dimer levels can prompt further imaging such as bedside ultrasound and CT to rapidly diagnose acute aortic dissection in patients with atypical presentations.
Answers are grounded in this paper and cite their sources.
May support D-dimer to trigger bedside ultrasound in atypical aortic dissection; single case leaves open need for prospective validation.
We present a case of an 84-year-old woman who presented with vague abdominal discomfort and syncope secondary to a type A acute aortic dissection. In pursuit of the diagnosis, multiple tests were ordered after the history and physical exam were complete. When the D-dimer levels were reported to be high, a bedside transthoracic ultrasound was performed which showed dilated aortic root and pericardial tamponade, leading us to order a computerized tomography to confirm the diagnosis of acute aortic dissection. A diagnostic testing algorithm being used in our institution using D-dimer, ultrasound, and other tests are provided in patients presenting with possible acute aortic dissection. In this case, bedside ultrasound helped us to rapidly make the diagnosis of acute aortic dissection and arrange for further inpatient care.
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Ünlüer et al. (2013) conducted a case report in Type A acute aortic dissection (n=1). D-dimer test and bedside transthoracic ultrasound was evaluated on Diagnosis of acute aortic dissection. High D-dimer levels prompted a bedside ultrasound that rapidly identified a dilated aortic root and pericardial tamponade, leading to the diagnosis of acute aortic dissection.
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