Chronic aortic dissection presenting as a prolonged febrile disease and arterial embolization.
Aortic dissection most often is an acute event dominated by excruciating pain and other symptoms which suggest the diagnosis. Our report and a review of the medical literature demonstrate that chronic aortic dissection may, rarely, present as a prolonged febrile illness, with night sweats, weight loss, pleural effusion, and little or no pain. These symptoms may be associated with a markedly elevated erythrocyte sedimentation rate (ESR), anemia of chronic disease, and hyperglobulinemia. Awareness of this unusual presentation, a high index of suspicion, and confirmation by an appropriate imagine technique (CT or MRI of the chest or transesophageal echocardiography have a very high sensitivity) will result in earlier diagnosis and better patient outcome.
Schattner
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Department of Medicine, A, Kaplan Hospital, Rehovot, Israel.
Klepfish
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Caspi
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D000368:Aged; D000753:Anemia, Refractory / Q000209:etiology; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D002908:Chronic Disease; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D013923:Thromboembolism / Q000209:etiology