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Aortic dissection associated with blunt chest trauma diagnosed by elevated D-dimer.

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  • 1Harvard Affiliated Emergency Medicine Residency, Department of Emergency Medicine, Harvard Medical School, 75 Francis Street, Neville House - 236A, Boston, Massachusetts 02115, USA.

International Journal of Surgery Case Reports
|March 26, 2015
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Summary

The serum D-dimer test, typically used for spontaneous aortic dissection, may aid in diagnosing traumatic aortic injury after blunt chest trauma, especially when classic signs are absent. This case highlights its potential utility in identifying aortic injuries in low-risk patients.

Keywords:
Aortic dissectionBovine-type aortic archChest traumaD-dimer

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Area of Science:

  • Cardiovascular Medicine
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Traumatic aortic dissection diagnosis relies on clinical evaluation, imaging, and historically, serum D-dimer for spontaneous cases.
  • The utility of D-dimer in diagnosing aortic injury following blunt trauma remains largely unreported.
  • Aortic dissection can occur following blunt chest trauma, presenting diagnostic challenges.

Purpose of the Study:

  • To report a case of traumatic aortic dissection diagnosed using the serum D-dimer test.
  • To explore the potential role of D-dimer in diagnosing aortic injury in blunt trauma patients.
  • To discuss the implications of D-dimer testing in the context of traumatic aortic injury.

Main Methods:

  • Case presentation of a 61-year-old male with chest pain after blunt chest trauma.
  • Diagnostic workup included history, physical examination, chest radiograph, and serum D-dimer testing.
  • Review of literature regarding D-dimer use in aortic dissection and trauma.

Main Results:

  • The patient presented with chest pain post-blunt trauma and had no prior history or risk factors for aortic disease.
  • Initial clinical assessment and chest radiograph did not reveal classic signs of aortic dissection.
  • An elevated serum D-dimer level fortuitously led to the diagnosis of aortic dissection.

Conclusions:

  • Serum D-dimer testing may serve as a valuable diagnostic tool for aortic injuries in patients with blunt chest trauma.
  • The D-dimer test could be particularly useful in low-risk trauma patients where traditional diagnostic indicators are absent.
  • This case underscores the importance of considering D-dimer in the diagnostic algorithm for suspected traumatic aortic injury.