Search

Background: Aortic dissection is a rare and important emergency condition, which usually involves a high mortality rate. Yet, early diagnosis of the disorder would increase the survival rate significantly. Objectives: The present systematic study and meta-analysis aimed at investigating the efficiency of D-dimer test in diagnosis of aortic dissection. Materials and Methods: The data used in this study were extracted from PubMed, Scopus, Elsevier, Springer, and Willey databases. Specificity, D-dimer, Sensitivity, and Aortic Dissection were the valid keywords used to extract the related articles. Totally, 11 papers published during 1998 - 2007 were selected. I2 index was used to assess heterogeneity across the studies. Results: A total of 596 subjects (averagely 54.5 ones in each study) were examined in the present research and 11 articles were entered into the final meta-analysis. According to the findings, the mean of the specificity test was 0.66 (0.54 - 0.78), with I2 index = 74.9% and p-value = 0.001. Additionally, the mean of the sensitivity test was 0.98 with I2 index = 606% and p-value = 0.381. Moreover, the mean D-dimer plasma level was 18.6 ug/mL in patients suffering from aortic dissection. Conclusion: This study showed the high efficiency of D-dimer test in diagnosis of aortic dissection. Thus, physicians are recommended to apply this quick and inexpensive method when a final diagnosis has not been made yet. Early diagnosis of aortic dissection via D-dimer test would result in implementation of the necessary treatments, eventually leading to a significant decrease in mortality rate.

Peripartum cardiomyopathy is a form of dilated cardiomyopathy that is defined as deterioration in cardiac function presenting typically between the last month of pregnancy and up to five months postpartum. As with other forms of dilated cardiomyopathy, PPCM involves systolic dysfunction of the heart with a decrease of the left ventricular ejection fraction with associated congestive heart failure. In heart failure sinus tachycardia is a poor prognostic factor and the common symptom. In this paper, we presented a case treated with ivabradine which provided additional benefit in patient with acute heart failure.