Aortic dissection laboratory findings

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Aortic dissection Microchapters

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Differentiating Aortic dissection from other Diseases

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Case #1


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:

  • D-dimer elevation
  • Troponin elevation
  • CK-MB elevation
  • Hematuria

D-dimer

  • Aortic dissection is more likely in the case of elevated D-dimer levels. It worths mentioning that compared to other causes of D-dimer elevation, aortic dissection leads to immediate rather than gradual increase in D-dimer level. D-dimer elevation has highest diagnostic value in the first hour of symptom presentation.[1]

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.[2]
  • The presence of an elevated CK MB may indicate the presence of concurrent acute myocardial infarction.[3]

Biomarker Studies

Urinalysis

References

  1. Rogers, Adam M.; Hermann, Luke K.; Booher, Anna M.; Nienaber, Christoph A.; Williams, David M.; Kazerooni, Ella A.; Froehlich, James B.; O'Gara, Patrick T.; Montgomery, Daniel G.; Cooper, Jeanna V.; Harris, Kevin M.; Hutchison, Stuart; Evangelista, Arturo; Isselbacher, Eric M.; Eagle, Kim A. (2011). "Sensitivity of the Aortic Dissection Detection Risk Score, a Novel Guideline-Based Tool for Identification of Acute Aortic Dissection at Initial Presentation". Circulation. 123 (20): 2213–2218. doi:10.1161/CIRCULATIONAHA.110.988568. ISSN 0009-7322.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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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