Aortic dissection laboratory findings: Difference between revisions

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__NOTOC__
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{{Template:Aortic dissection}}
{{Template:Aortic dissection}}
 
{{CMG}}; '''Associate Editor-In-Chief:''' {{Sahar}} {{CZ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
 
==Overview==  
==Overview==  
Routine blood work is usually not helpful and should not delay definitive [[diagnosis|diagnostic studies]] such as a [[CT]] scan and treatment. [[Hemolysis]] can be present as a result of blood in the [[false lumen]]. The presence of an elevated [[CK MB]] may indicate the presence of concomitant [[acute myocardial infarction]] (often a [[right coronary artery]] occlusion due to occlusion of the [[ostium]] of the [[RCA]] by the dissection). [[Hematuria]] may be present and may indicate the presence of [[renal infarction]].
There is no particular laboratory findings for the diagnosis of aortic dissection. Possible laboratory findings associated with aortic dissection may include troponin elevation, CK-MB elevation, hematuria, and etc. There has been reports of using a [[smooth muscle]] [[myosin]] heavy chain [[immunoassay]] to help [[diagnosis|diagnose]] [[aortic]] dissection.
==Laboratory Findings==
==Laboratory Findings==
===Complete Blood Count===
There is no particular laboratory findings for the diagnosis of aortic dissection. Possible laboratory findings associated with aortic dissection may include:
[[Hemolysis]] can be present as a result of blood in the [[false lumen]].
*Troponin elevation
*CK-MB elevation
*Hematuria
===Cardiac Biomarkers===
*Troponin elevation may be observed in approximately 25% of patients with aortic dissection type A. It may be the result of hemodynamic stress and is not associated with poorer prognosis.<ref name="BONNEFOYGODON2005">{{cite journal|last1=BONNEFOY|first1=Eric|last2=GODON|first2=Patrick|last3=KIKORIAN|first3=Gilbert|last4=CHABAUD|first4=Sylvie|last5=TOUBOUL|first5=Paul|title=Significance of serum troponin I elevation in patients with acute aortic dissection of the ascending aorta|journal=Acta Cardiologica|volume=60|issue=2|year=2005|pages=165–170|issn=0001-5385|doi=10.2143/AC.60.2.2005027}}</ref>
*The presence of an elevated [[CK MB]] may indicate the presence of concurrent [[acute myocardial infarction]].<ref name="Davidson1988">{{cite journal|last1=Davidson|first1=E.|title=Elevated serum creatine kinase levels. An early diagnostic sign of acute dissection of the aorta|journal=Archives of Internal Medicine|volume=148|issue=10|year=1988|pages=2184–2186|issn=00039926|doi=10.1001/archinte.148.10.2184}}</ref>
===Biomarker Studies===
===Biomarker Studies===
*There has been one report using a [[smooth muscle]] [[myosin]] heavy chain [[immunoassay]] to help [[diagnosis|diagnose]] [[aortic]] dissection. They report that a level > 10 ng/ml within the first 12h is 90% [[sensitivity|sensitive]] and 97% [[specificity|specific]]. This finding needs to be confirmed in other trials however.
*There has been reports of using a [[smooth muscle]] [[myosin]] heavy chain [[immunoassay]] to help [[diagnosis|diagnose]] [[aortic]] dissection.<ref name="Suzuki1997">{{cite journal|last1=Suzuki|first1=T.|title=Biochemical Diagnosis of Acute Aortic Damage - Diagnosis of Aortic Dissection and Traumatic Aortic Rupture Using an Immunoassay of Smooth Muscle Myosin Heavy Chain|year=1997|pages=3–10|doi=10.1007/978-3-642-60735-6_1}}</ref><ref name="Suzuki2000">{{cite journal|last1=Suzuki|first1=Toru|title=Diagnostic Implications of Elevated Levels of Smooth-Muscle Myosin Heavy-Chain Protein in Acute Aortic Dissection: The Smooth Muscle Myosin Heavy Chain Study|journal=Annals of Internal Medicine|volume=133|issue=7|year=2000|pages=537|issn=0003-4819|doi=10.7326/0003-4819-133-7-200010030-00013}}</ref>
*The presence of an elevated [[CK MB]] may indicate the presence of concomitant [[acute myocardial infarction]] (often a [[right coronary artery]] occlusion due to occlusion of the [[ostium]] of the [[RCA]] by the dissection).
===Urinalysis===
===Urinalysis===
*[[Hematuria]] may be present and may indicate the presence of [[renal infarction]].
*[[Hematuria]] may be present and may indicate the presence of [[renal infarction]].<ref name="KodamaNoda2013">{{cite journal|last1=Kodama|first1=Koichi|last2=Noda|first2=Toru|last3=Motoi|first3=Isamu|title=Nutcracker phenomenon: An unusual presentation of acute aortic dissection|journal=Indian Journal of Urology|volume=29|issue=1|year=2013|pages=67|issn=0970-1591|doi=10.4103/0970-1591.109990}}</ref>
 
There are no diagnostic laboratory findings associated with [disease name].
 
OR
 
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
 
OR
 
[Test] is usually normal among patients with [disease name].
 
OR
 
Laboratory findings consistent with the diagnosis of [disease name] include:
 
[Abnormal test 1]
[Abnormal test 2]
[Abnormal test 3]
OR
 
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 21:10, 3 December 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sahar Memar Montazerin, M.D.[2] Cafer Zorkun, M.D., Ph.D. [3]

Overview

There is no particular laboratory findings for the diagnosis of aortic dissection. Possible laboratory findings associated with aortic dissection may include troponin elevation, CK-MB elevation, hematuria, and etc. There has been reports of using a smooth muscle myosin heavy chain immunoassay to help diagnose aortic dissection.

Laboratory Findings

There is no particular laboratory findings for the diagnosis of aortic dissection. Possible laboratory findings associated with aortic dissection may include:

  • Troponin elevation
  • CK-MB elevation
  • Hematuria

Cardiac Biomarkers

  • Troponin elevation may be observed in approximately 25% of patients with aortic dissection type A. It may be the result of hemodynamic stress and is not associated with poorer prognosis.[1]
  • The presence of an elevated CK MB may indicate the presence of concurrent acute myocardial infarction.[2]

Biomarker Studies

Urinalysis

References

  1. ↑ BONNEFOY, Eric; GODON, Patrick; KIKORIAN, Gilbert; CHABAUD, Sylvie; TOUBOUL, Paul (2005). "Significance of serum troponin I elevation in patients with acute aortic dissection of the ascending aorta". Acta Cardiologica. 60 (2): 165–170. doi:10.2143/AC.60.2.2005027. ISSN 0001-5385.
  2. ↑ Davidson, E. (1988). "Elevated serum creatine kinase levels. An early diagnostic sign of acute dissection of the aorta". Archives of Internal Medicine. 148 (10): 2184–2186. doi:10.1001/archinte.148.10.2184. ISSN 0003-9926.
  3. ↑ Suzuki, T. (1997). "Biochemical Diagnosis of Acute Aortic Damage - Diagnosis of Aortic Dissection and Traumatic Aortic Rupture Using an Immunoassay of Smooth Muscle Myosin Heavy Chain": 3–10. doi:10.1007/978-3-642-60735-6_1.
  4. ↑ Suzuki, Toru (2000). "Diagnostic Implications of Elevated Levels of Smooth-Muscle Myosin Heavy-Chain Protein in Acute Aortic Dissection: The Smooth Muscle Myosin Heavy Chain Study". Annals of Internal Medicine. 133 (7): 537. doi:10.7326/0003-4819-133-7-200010030-00013. ISSN 0003-4819.
  5. ↑ Kodama, Koichi; Noda, Toru; Motoi, Isamu (2013). "Nutcracker phenomenon: An unusual presentation of acute aortic dissection". Indian Journal of Urology. 29 (1): 67. doi:10.4103/0970-1591.109990. ISSN 0970-1591.

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