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October 7, 1974

Dissecting Aneurysm

Author Affiliations

St. Joseph's Hospital Hamilton, Ontario, Canada

JAMA. 1974;230(1):34. doi:10.1001/jama.1974.03240010018005

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To the Editor.—  We have a patient who has been dependent on dialysis for the past six years and who survived an aortic dissection some 2 1/2 years ago, like that reported by Chiorazzi et al (228:1146, 1974).This patient, now 37 years of age, was first seen in 1968, at which time he was found to have terminal renal failure with a serum creatinine clearance of 18.2 mg/100 ml. His primary diagnosis was chronic glomerulonephritis. It was believed that since he had malignant hypertension, his renal function had deteriorated more rapidly than the natural course of the chronic glomerulonephritis. His blood pressure at that time was 230/150 mm Hg and his fundi showed large amounts of exudates, hemorrhages, and papilledema, bilaterally. Neurological examination at this time was normal. Because he was a Jehovah's Witness (at that time we were still giving blood intermittently to hemodialysis patients), he was given