Elevated D-dimer in patient with acute aortic dissection

Acute aortic dissection is an uncommon but potentially catastrophic vascular emergency. Assessment of risk factors is important for the diagnosis. These include chest pain features, blood pressure differential more than 20 mmHg and aortic enlargement on chest X-ray. Physical examination, electrocardiogram, chest X-ray, transthoracic echocardiography are readily available in emergency departments but typically are not sufficient to rule out the diagnosis. CT angiography, transesophageal or magnetic resonance angiography must be performed to confirm diagnosis. D-dimer testing has been identified in prior studies as a biomarker helpful for screening of patients, with cut-off values similar to pulmonary embolism. D-dimer may help triage patients with low or intermediate risk.