title: When does a D-dimer test help make the diagnosis of aortic dissection?
abstract: We present a case of an 84-year-old woman who presented with vague abdominal discomfort and syncope secondary to a type A acute aortic dissection. In pursuit of the diagnosis, multiple tests were ordered after the history and physical exam were complete. When the D-dimer levels were reported to be high, a bedside transthoracic ultrasound was performed which showed dilated aortic root and pericardial tamponade, leading us to order a computerized tomography to confirm the diagnosis of acute aortic dissection. A diagnostic testing algorithm being used in our institution using D-dimer, ultrasound, and other tests are provided in patients presenting with possible acute aortic dissection. In this case, bedside ultrasound helped us to rapidly make the diagnosis of acute aortic dissection and arrange for further inpatient care.
authors.affiliation: Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital Izmir Turkey.
authors.forename: Erden Erol
authors.initials: EE
authors.lastname: Unlüer
authors.affiliation: Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital Izmir Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Karagöz
authors.affiliation: Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital Izmir Turkey.
authors.forename: Pinar Yeşim
authors.initials: PY
authors.lastname: Akyol
keywords: D-dimer; aortic dissection; bedside ultrasonography; emergency department