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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Using Age-Adjusted D-Dimer vs Traditional D-Dimer to Rule Out Acute Aortic Syndromes.

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The Journal of Emergency Medicine
|September 27, 2025
PubMed
Summary
This summary is machine-generated.

Age-adjusted D-dimer (AADD) shows promise in ruling out acute aortic syndromes (AS) with comparable sensitivity to standard D-dimer (DD). Further research is needed to confirm its utility in emergency department settings.

Keywords:
ADD-RSD-dimeracute aortic dissectionage adjusted D-dimeraortic syndromes

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Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Acute aortic syndromes (AS) are rare, life-threatening conditions requiring rapid diagnosis.
  • Mortality risk for AS increases significantly with delayed diagnosis.
  • Standard D-dimer (DD) testing aids in ruling out AS in low-risk patients but lacks specificity.

Purpose of the Study:

  • To evaluate the diagnostic utility of age-adjusted D-dimer (AADD) in ruling out AS.
  • To compare AADD performance against standard DD levels (< 500 ng/dL).
  • To assess the role of the Aortic Dissection Detection Risk Score (ADD-RS) in conjunction with these tests.

Main Methods:

  • Retrospective analysis of 5818 emergency department patients from 2012-2021.
  • Inclusion criteria: patients undergoing computed tomography angiography (CTA) for suspected aortic conditions.
  • Exclusion criteria: pregnancy, prior aortic dissection/repair, altered mental status, age < 18.

Main Results:

  • Standard DD (< 500 ng/dL) showed 97.9% sensitivity and 72.7% specificity for AS.
  • AADD demonstrated 93.8% sensitivity and 78.1% specificity.
  • AADD exhibited comparable sensitivity to DD, with a statistically significant increase in specificity (p < 0.05).

Conclusions:

  • AADD presents a potentially valuable tool for ruling out AS, offering similar sensitivity to DD.
  • AADD may provide improved specificity compared to standard DD testing.
  • Further prospective trials are recommended to validate AADD's role in clinical practice, potentially aided by ADD-RS.