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BMJ Case Rep. 2010; 2010: bcr0420102943.
Published online 2010 August 31. doi:  10.1136/bcr.04.2010.2943
PMCID: PMC3029515
Reminder of important clinical lesson

D-dimer is elevated in acute aortic dissection


This case illustrates that d-dimer is elevated in patients with acute aortic dissection. A 49-year-old woman presented with central, crushing chest pain exacerbated on inspiration. The chest pain was associated with right-leg numbness and pain, although peripheral pulses and blood pressures were normal. Routine bloods demonstrated an elevated d-dimer with a normal ECG and chest x-ray radiograph. A differential diagnosis of pulmonary embolism and acute aortic dissection was made. CT-angiogram showed type B aortic dissection. This case report highlights the mounting evidence that d-dimer is elevated in practically all incidents of aortic dissection and could be useful as a negative predictive marker.

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