Using D-Dimer to Diagnose Painless Acute Aortic Dissection : A Case Report

Abstract EN

Introduction.

Aortic dissection is a cardiovascular emergency; the most frequent symptom is chest pain, but clinical presentation can be varied and atypical.

Case Presentation.

We report the case of a 66-year-old Caucasian male who presented a syncope immediately followed by a left-arm weakness while driving his car.

Clinical examination was normal, but bilateral jugular vein distension was noted.

Electrocardiogram and chest radiography were unremarkable.

Among blood tests performed, troponin I test result was negative, and D-dimer test concentration was >4000 ng/mL.

Since D-dimer test result was positive, chest computer tomography angiogram was performed and found a thoracic aortic dissection.

Conclusion.

Our case report shows that acute aortic dissection diagnosis is difficult and must be associated with the interpretation of various clinical signs and D-dimer measurement.

It could be helpful for the emergency physician to have a pretest probability D-dimer like in pulmonary embolism diagnosis.