Aortic dissection--in pursuit of a serum marker

Should every patient with suspected aortic dissection undergo imaging? Of course. In a medical world with unlimited resources, that does not exist. A serum test for suspected aortic dissection would prove highly useful for low- and intermediate-risk populations and together with troponin and d-dimer may become part of a "Chest-Pain Panel" in the emergency department. Last decade has seen a myriad of serum markers being tested for this indication. It seems that quantitative d-dimer has an excellent negative predictive value for ruling out aortic dissection under appropriate context. Other blood tests focus on myosin heavy chain and metalloproteinase release for the aortic media during dissection. The future seems promising.