At the "threshold" of certainty: Risk stratification and clinical assessment incongruity in the diagnosis of aortic dissection

SAGE Open Medical Case Reports
Maxim ZlatopolskyMarcel Zughaib

Abstract

The use of D-dimer assay to screen for aortic dissection has become routine in clinical practice. Although an uncommon disease entity, aortic dissection is rapidly fatal without prompt diagnosis, and biochemical detection in the proper clinical context is crucial. We performed a retrospective chart review of all aortic dissections presenting to a community tertiary care center between 2000 and 2016 and identified three patients in whom laboratory D-dimer testing was positive and a diagnosis of Stanford Type A aortic dissection was confirmed with computed tomography angiography based on clinical assessment and a newly validated risk stratification tool.

References

Feb 24, 2000·JAMA : the Journal of the American Medical Association·P G HaganK A Eagle
Aug 18, 2004·Journal of the American College of Cardiology·Holger EggebrechtRaimund Erbel
Mar 25, 2006·Critical Care Medicine·Patrick OhlmannPierre Bareiss
Jul 14, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher KabrhelJeffrey A Kline
Jul 14, 2010·Circulation·Alan C Braverman
Oct 30, 2010·Journal of the American College of Cardiology·Aaron M Ranasinghe, Robert S Bonser

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