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Article
June 23, 1956

VARIED MANIFESTATIONS OF DISSECTING ANEURYSM OF THE AORTA

JAMA. 1956;161(8):689-692. doi:10.1001/jama.1956.02970080019007
Abstract

• Dissecting aneurysm of the aorta was correctly diagnosed ante mortem in 34 out of 86 patients who were found at autopsy to have this condition. Its symptoms are extremely varied. Pain, which was excruciating in some patients, was absent in 42 of the 86. The syndrome may be described as cardiovascular, pulmonary, abdominal, renal, or neurological, depending on the dominant group of symptoms and signs. To the neurological syndrome belong shock, hemiplegia, coma, confusion, psychosis, and bizarre neurological defects that may draw attention away from the more essential findings. The bizarre neurological signs, with or without sudden thoracic or abdominal pain, with dyspnea, a diastolic bruit, and hemothorax on the left, were valuable diagnostic signs. Fifty of the 86 cases were in men over 50 years old. Increasing attention to these facts in older patients with hypertension should improve the accuracy of diagnosis and the prospects of successful treatment.

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