The role of biomarkers in the diagnosis of acute aortic dissection

Abstract

Aortic dissection (AD), is characterised by the spontaneous development of false lumen in the innermost layer of the aorta and can present at various sites, with the ascending aorta being the most frequent location for its presentation. (1,2) Aortic dissections have a pathophysiologic sequence that includes aortic wall inflammation, apoptosis of vascular smooth muscle cells, aortic media degeneration due to inflammatory cell infiltration in the aortic media, elastin disruption, and vessel dissection. (1 ),(3) Consequently, immediate and accurate management and intervention are required, as mortality rates after the rupture exceed 80%.(2),(3) Acute aortic dissection presents a great diagnostic challenge, as its typical signs and symptoms are nonspecific. The most common symptom includes acute onset of tearing chest, as well as pain in the back or abdomen, often described as 'sharp'. (1,2) Hypertension is a significant factor. Imaging tests are used to make a diagnosis, including transesophageal echocardiography, CT angiography, MRI, and contrast aortography, with recent studies showing that on a posterior-anterior chest x-ray, a widened mediastinum may also be a clinical presentation of aortic dissection.