Aortic dissection : an unusual presentation

Abstract

Aortic dissection classically presents acutely with severe chest pain. Rarely, chronic dissection can exhibit atypical features, including persistent fever and malaise. This article describes a case where the patient presented with fever and bilateral pleural effusions associated with chronic dissection of the aorta that was also misdiagnosed on computed tomography of the aorta. This case outlines the difficulty in diagnosing aortic dissection secondary to a circumferential tear of the intima, whereby imaging modalities can indicate a perforated supravalvular aortic membrane rather than dissection. The case also shows the importance of fever and pleural effusions as indicators of pathology of the thoracic aorta.