Veyssier-Belot C, de Gennes C, Papo T, Cacoub P, Amarenco P, Blétry O, Wechsler B, Godeau P, Kieffer E, Piette J C
Service de médecine interne B, centre hospitalier de Poissy-Saint-Germain-en-Laye, France.
Rev Med Interne. 1998 Oct;19(10):704-8. doi: 10.1016/s0248-8663(98)80704-2.
Aortic 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.
We retrospectively reviewed cases of chronic aortic dissections seen in a department of internal medicine and a department of neurology between 1975 and 1992.
We 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.
Chronic 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.
由于缺乏轻至中度胸痛，主动脉弓夹层有时可能被误诊。确诊往往在夹层已经发生超过15天之后，此后被视为慢性夹层。主动脉夹层随后可能表现为以发热和/或炎症为主要症状的持续性发热性疾病，疼痛轻微或无疼痛。
我们回顾性分析了1975年至1992年间在内科和神经科所见的慢性主动脉夹层病例。
我们报告了6例主动脉夹层患者，并描述了根据胸部计算机断层扫描或经食管超声心动图证据确诊后的结局及治疗情况。4例患者接受了主动脉弓手术修复，1例患者接受了β受体阻滞剂治疗。
很少有慢性主动脉夹层导致发热或血沉加快的报道。对于这些特殊患者的治疗管理，医疗团队和外科团队之间必须进行讨论。
