Aortic dissection masquerading as systemic disease--the post-dissection syndrome

Three patients presented with a prolonged illness accompanied by fever, weight loss, high ESR, neutrophilia, abnormal liver function tests, urinary abnormalities and, in one case, splinter haemorrhages and impairment of renal function. Aortic dissection was diagnosed 3-12 weeks after the onset of the illness, and probably accounted for the entire syndrome. All abnormalities resolved spontaneously over the following months. There are few similar cases in the literature, and the syndrome could easily pass unrecognized. Aortic dissection should be considered as a possible cause of any systemic illness of sudden onset, but especially if there is an initial history of chest or abdominal pain, or evidence of previous hypertension or other risk factors.