D DIMERS - A POWERFUL TOOL IN THE DIAGNOSIS OF AORTIC DISSECTION

Abstract

Introduction: Acute aortic syndrome is one of the most life threatening cardivascular conditions besides acute coronary syndrome and pulmonary embolism. Fifty percent of all the patients with aortic dissection do not survive for surgery or other therapeutic procedure to be performed and they experience a lethal end. D dimers although are a marker with a low specificity and sensitivity they can help us and guide us to make the right diagnosis. Aim: Using d dimers to raise the suspicion for acute aortic dissection and using the triple chest pain CT angiography protocol to confirm the right diagnosis. Case report: This series of case reports are about a few patients that presented in the emergency department with either a chest or back pain which was radiating to different body regions (including the lumbal region and the abdominal area). As these symptoms can sometime overlap and manifest as different acute cardiovascular syndromes, which can lead to increased morbidity and mortality, a CT angiography was performed after the regular noninvasive, low cost echocardiography was done to potentially find a possible diagnosis and show us the right diagnostic path. D dimers were also examined in all of the patients and increased level was found in all of the above mentioned. Aortic dissection (Stanford A or B ) was the final diagnosis in all of them, every single patient requiring a different therapeutic approach. Conclusion: D dimers in combination with a good clinical examination can be a perfect tool to raise the suspicion for acute aortic syndrome and after performing a triple chest pain protocol with CT angiography we can confirm and treat the diagnosis which requested a hospital admission.