title: Case report and literature review of a dissecting thoracic aneurysm in a 16-year-old boy presenting to the emergency department.
abstract: BACKGROUND
  Aortic dissection is a rare occurrence in the pediatric and adolescent population. It has numerous etiologies, including congenital cardiac abnormalities. Aortic dissection has a high mortality rate; therefore, it is essential for the physician to at least consider this diagnosis in the setting this patient presented within their differential of atypical chest pain in the pediatric and adolescent population.
  
  
  OBJECTIVE
  The purpose of this case is to consider an aortic dissection as part of the differential in a pediatric or adolescent patient presenting with atypical chest pain and abnormal vital signs. Second, this case demonstrates the diagnostic value of the D-dimer assay as a potential screening tool of aortic dissection.
  
  
  METHODS
  A 16-year-old boy with a benign past medical history presented to the Emergency Department (ED) with sudden onset of chest pain. His diagnostic workup led to a diagnosis of aortic dissection. It is noted that his D-dimer was significantly elevated.
  
  
  CONCLUSIONS
  It is important to consider aortic dissection as a possibility when assessing the sick adolescent patient. The D-dimer is quite useful as a rapid and inexpensive test in the evaluation and stratification of adolescent chest pain patients in the ED.
authors.affiliation: Department of Surgery, Howard University, Washington, DC.
authors.forename: Bharat
authors.initials: B
authors.lastname: Kothakota
authors.affiliation: Department of Emergency Medicine, Howard University, Washington, DC.
authors.forename: Johnnie
authors.initials: J
authors.lastname: Ford
mesh_terms: D000293:Adolescent; D000784:Aortic Dissection / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D002637:Chest Pain / Q000175:diagnosis; D003937:Diagnosis, Differential; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008297:Male
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: D-dimer; aortic dissection; pediatric; radiology; thoracic aneurysm