CHRONIC AORTIC DISSECTION PRESENTING AS A PROLONGED FEBRILE DISEASE AND ARTERIAL EMBOLIZATION

Aortic dissection most often is an acute event dominated by excruciati ng pain and other symptoms which Suggest the diagnosis. Our report and a review of the medical literature demonstrate that chronic aortic di ssection may, rarely, present as a prolonged febrile illness, with nig ht sweats, weight loss, pleural effusion, and little or no pain. These symptoms may be associated with a markedly elevated erythrocyte sedim entation rate (ESR), anemia of chronic disease, and hyerglobulinemia. Awareness of this unusual presentation, a high index of suspicion, and confirmation by an appropriate imaging technique (CT or MRI of the ch est or transesophageal echocardiography have a very high sensitivity) will result in earlier diagnosis and better patient outcome.