• C Veyssier-Belot, C de Gennes, T Papo, P Cacoub, P Amarenco, O Blétry, B Wechsler, P Godeau, E Kieffer, and J C Piette.
• Service de médecine interne B, centre hospitalier de Poissy-Saint-Germain-en-Laye, France.
• Rev Med Interne. 1998 Oct 1; 19 (10): 704708704-8.

PurposeAortic arch dissection may be sometimes misdiagnosed due to the lack of mild to moderate chest pain. Definite diagnosis is often made while dissection has already occurred more than 15 days ago, being thereafter considered as chronic. Aortic dissection may then present as a prolonged febrile illness with fever and/or inflammation as main symptoms, with little or no pain.MethodsWe retrospectively reviewed cases of chronic aortic dissections seen in a department of internal medicine and a department of neurology between 1975 and 1992.ResultsWe report six cases of patients presenting with aortic dissection and describe their outcome and treatments after the diagnosis was made based on either thoracic computerized tomography or trans-esophageal echocardiography evidence. Four patients had surgical aortic arch repair while one patient was treated with beta-blockers.ConclusionChronic aortic dissection has rarely been reported to cause fever or increased sedimentation rate. Treatment has to be discussed between medical and surgical teams involved in the therapeutical management of these unusual patients.

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