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Case Reports in Emergency Medicine
Volume 2011, Article ID 395613, 3 pages
http://dx.doi.org/10.1155/2011/395613
Case Report

Using D-Dimer to Diagnose Painless Acute Aortic Dissection: A Case Report

Pôle de Médecine d'Urgence, Hôpitaux Universitaires de Toulouse, CHU Purpan, TSA 40031, 31059 Toulouse Cedex 9, France

Received 20 June 2011; Accepted 7 July 2011

Academic Editors: K. Imanaka and R. Krittayaphong

Copyright © 2011 Caroline Barniol et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Aortic dissection is a cardiovascular emergency; the most frequent symptom is chest pain, but clinical presentation can be varied and atypical. Case Presentation. We report the case of a 66-year-old Caucasian male who presented a syncope immediately followed by a left-arm weakness while driving his car. Clinical examination was normal, but bilateral jugular vein distension was noted. Electrocardiogram and chest radiography were unremarkable. Among blood tests performed, troponin I test result was negative, and D-dimer test concentration was >4000 ng/mL. Since D-dimer test result was positive, chest computer tomography angiogram was performed and found a thoracic aortic dissection. Conclusion. Our case report shows that acute aortic dissection diagnosis is difficult and must be associated with the interpretation of various clinical signs and D-dimer measurement. It could be helpful for the emergency physician to have a pretest probability D-dimer like in pulmonary embolism diagnosis.