The goal of this observational study is to determine the utility of desmosine, D-dimer and aggrecan as early diagnostic biomarkers in aortic dissection. The main questions it aims to answer are:

• To investigate the plasma levels of selected biomarkers in ED patients with confirmed aortic dissection
• To study the diagnostic performance of plasma levels of selected biomarkers for aortic dissection
• To study the association between plasma levels of selected biomarkers and clinical outcomes

Inclusion Criteria:

• Age ≥ 18 years

• Presentation to the ED with first 24 hours of symptoms suggesting AD, including chest pain, upper back pain, syncope of unknown cause, symptoms of any acute perfusion deficit

• Confirmed AD

  • the diagnosis of AD adjudicated by an independent expert panel at hospital discharge or death, whichever comes first
  • The expert panel will consist of (1) a specialist in Emergency Medicine and (2) a specialist in Cardiology and (3) a specialist in Cardiothoracic Surgery.

Exclusion Criteria:

• Age <18 years old
• Pregnancy
• Surgery or stenting performed before recruitment

Patients aged 18 years or above, with AD presenting to the ED within the first 24 hours of symptom onset will be recruited.