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CLINICAL REVIEW: Harald Herkner Challenge for emergency physicians BMJ 2003; 326: 1134 [Full text]

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D-dimer in Acute Aortic Dissection

Syed Viqarar Ahmed   (25 May 2003)

Time Is Life Saving Procedure !

Nathan P. Gottehrer   (30 May 2003)

D-dimer in Acute Aortic Dissection 25 May 2003
Syed Viqarar Ahmed, Specialist Registrar Medicine Milton Keynes General Hospital Send response to journal: Re: D-dimer in Acute Aortic Dissection	In this article it is mentioned that D-Dimer will help to differentiate the patients with Acute aortic dissection from Pulmonary embolism. Unfortunately this is not the correct statement. D-Dimer will be raised in both these conditions. In Aortic dissection, blood leaks into the false lumen and forms a clot and this results in exessive release of fibrinogen degradation products giving high values of D-dimer which is also expected to be high in Pulmonary Embolism by somewhat similar mechanism. Competing interests:   None declared
Time Is Life Saving Procedure ! 30 May 2003
Nathan P. Gottehrer, internal medicine health services fund Send response to journal: Re: Time Is Life Saving Procedure !	Dir Sir As you say awareness is the name of the game. In the past when I run the ED,we have around six cases that I remember in one year. We were lucky to have out of these cases four cases that go home. I think that we have to emphasis the most valuable diagnostic tool except our awareness, the time- our running seconds in the life watch. We lost our patients because two reasons, awareness and time. I think that this diagnostic tool have to more emphasis to our colleagues. Competing interests:   None declared