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[D-dimer in acute aortic dissection]
Jinan S Hassan Alshakarchi1, Nis Baun Høst
1Amtssygehuset i Glostrup, Medicinsk Afdeling M, Kardiovaskulaer Sektion, Glostrup.
Ugeskrift for Laeger
|August 25, 2005
Summary
D-dimer testing is a reliable diagnostic tool for pulmonary embolism. However, this study highlights two acute thoracic aortic dissection cases with extremely high D-dimer levels, questioning its initial diagnostic value for aortic dissection.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Imaging
- Emergency Medicine
Background:
- D-dimer testing is a standard diagnostic approach for pulmonary embolism, particularly when results are negative.
- Its utility in diagnosing other acute cardiovascular emergencies, such as aortic dissection, is less established.
Observation:
- Two cases of acute thoracic aortic dissection presented with exceptionally elevated D-dimer levels.
- These high values were noted despite D-dimer's typical use in ruling out pulmonary embolism.
Findings:
- The presence of very high D-dimer levels in these cases suggests a potential, albeit non-specific, indicator for aortic dissection.
- This challenges the conventional interpretation of D-dimer solely within the context of pulmonary embolism diagnosis.
Implications:
- Elevated D-dimer levels in patients with suspected aortic dissection warrant careful consideration and may necessitate further diagnostic workup.
- Re-evaluating the role and interpretation of D-dimer testing in the initial assessment of acute thoracic aortic dissection is recommended.