Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report
Dublin Core
Title
Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report
Subject
D-dimer, Thoracic Aorta Dissection, Chest Pains
Description
Abstract
Background Chest pain is a common reason patients are admitted to the hospital. The most clinically significant
cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection
(AAD). A prompt and correct diagnosis is crucial to patient survival. This case report of a patient who presented with
chest pain confirms the appropriateness of urgent imaging tests e.g. POCUS when AAD is suspected in high-risk
patients, regardless of the results of additional laboratory tests such as the D-dimer (DD) assay.
Case report A 72-year-old female patient was brought by the emergency medical team to the emergency room due
to fainting without loss of consciousness and severe chest pain. Owing to worsening hypotonia and recurrent chest
pain, a thoracic computed tomography (CT scan) was performed and subsequently revealed aortic dissection within
the ascending segment with bleeding into the pericardial sac. The results of previously ordered laboratory tests,
including the DD assay, were unremarkable and were obtained only after the thoracic CT scan had been acquired.
Despite prompt medical intervention, the patient died.
Conclusion Vigilance is required when diagnosing chest pain in high-risk patients who are suspected of having AAD.
The case presented in this report confirms the importance of a thorough history and physical examination as well
as prompt diagnostic imaging e.g. POCUS or CT scan. Dedicated laboratory tests such as the DD assay, while often
helpful, may fail to reveal remarkable abnormalities in time for medical intervention.
Keywords D-dimer, Thoracic Aorta Dissection, Chest Pains
Background Chest pain is a common reason patients are admitted to the hospital. The most clinically significant
cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection
(AAD). A prompt and correct diagnosis is crucial to patient survival. This case report of a patient who presented with
chest pain confirms the appropriateness of urgent imaging tests e.g. POCUS when AAD is suspected in high-risk
patients, regardless of the results of additional laboratory tests such as the D-dimer (DD) assay.
Case report A 72-year-old female patient was brought by the emergency medical team to the emergency room due
to fainting without loss of consciousness and severe chest pain. Owing to worsening hypotonia and recurrent chest
pain, a thoracic computed tomography (CT scan) was performed and subsequently revealed aortic dissection within
the ascending segment with bleeding into the pericardial sac. The results of previously ordered laboratory tests,
including the DD assay, were unremarkable and were obtained only after the thoracic CT scan had been acquired.
Despite prompt medical intervention, the patient died.
Conclusion Vigilance is required when diagnosing chest pain in high-risk patients who are suspected of having AAD.
The case presented in this report confirms the importance of a thorough history and physical examination as well
as prompt diagnostic imaging e.g. POCUS or CT scan. Dedicated laboratory tests such as the DD assay, while often
helpful, may fail to reveal remarkable abnormalities in time for medical intervention.
Keywords D-dimer, Thoracic Aorta Dissection, Chest Pains
Creator
Alicja Stankiewicz1*, Beata Moczulska1
, Wiktoria Izdebska2
, Aleksandra Wińska3
and Leszek Gromadziński1
, Wiktoria Izdebska2
, Aleksandra Wińska3
and Leszek Gromadziński1
Source
https://doi.org/10.1186/s12245-025-00811-9
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Alicja Stankiewicz1*, Beata Moczulska1
, Wiktoria Izdebska2
, Aleksandra Wińska3
and Leszek Gromadziński1, “Acute aortic dissection on CT: is D-dimer determination useful for a timely and correct diagnosis? A case report,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12630.