Kothakota Bharat, Ford Johnnie
Department of Surgery, Howard University, Washington, DC.
Department of Emergency Medicine, Howard University, Washington, DC.
J Emerg Med. 2014 Feb;46(2):e55-9. doi: 10.1016/j.jemermed.2013.08.041. Epub 2013 Dec 2.
Aortic dissection is a rare occurrence in the pediatric and adolescent population. It has numerous etiologies, including congenital cardiac abnormalities. Aortic dissection has a high mortality rate; therefore, it is essential for the physician to at least consider this diagnosis in the setting this patient presented within their differential of atypical chest pain in the pediatric and adolescent population.
The purpose of this case is to consider an aortic dissection as part of the differential in a pediatric or adolescent patient presenting with atypical chest pain and abnormal vital signs. Second, this case demonstrates the diagnostic value of the D-dimer assay as a potential screening tool of aortic dissection.
A 16-year-old boy with a benign past medical history presented to the Emergency Department (ED) with sudden onset of chest pain. His diagnostic workup led to a diagnosis of aortic dissection. It is noted that his D-dimer was significantly elevated.
It is important to consider aortic dissection as a possibility when assessing the sick adolescent patient. The D-dimer is quite useful as a rapid and inexpensive test in the evaluation and stratification of adolescent chest pain patients in the ED.
主动脉夹层在儿童和青少年人群中较为罕见。其病因众多，包括先天性心脏异常。主动脉夹层死亡率很高；因此，对于医生来说，在儿科和青少年人群出现非典型胸痛的鉴别诊断中，至少考虑这一诊断至关重要。
本病例的目的是将主动脉夹层作为儿科或青少年患者出现非典型胸痛和生命体征异常时鉴别诊断的一部分。其次，本病例展示了D-二聚体检测作为主动脉夹层潜在筛查工具的诊断价值。
一名既往病史良性的16岁男孩因突发胸痛就诊于急诊科。其诊断检查结果确诊为主动脉夹层。值得注意的是，他的D-二聚体显著升高。
在评估患病青少年患者时，考虑主动脉夹层的可能性很重要。D-二聚体作为急诊科青少年胸痛患者评估和分层的快速且廉价的检测方法非常有用。
