Aortic dissection laboratory findings

Aortic dissection Microchapters
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Case #1

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

Overview

Routine blood work is usually not helpful and should not delay definitive 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.

Laboratory Findings

Complete Blood Count

Hemolysis can be present as a result of blood in the false lumen.

Biomarker Studies

• There has been one report using a smooth muscle myosin heavy chain immunoassay to help diagnose aortic dissection. They report that a level > 10 ng/ml within the first 12h is 90% sensitive and 97% specific. This finding needs to be confirmed in other trials however.
• 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

• Hematuria may be present and may indicate the presence of renal infarction.