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Gepubliceerd in: Netherlands Heart Journal 9/2017

Open Access 25-07-2017 | Letter to the Editor

Aortic dissection, a diagnostic challenge

Auteurs: W. W. Jansen Klomp, A. P. Nierich, A. W. J. van ’t Hof

Gepubliceerd in: Netherlands Heart Journal | Uitgave 9/2017

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Response to the letter from Siniorakis et al: Fever as a first manifestation of acute aortic dissection. DOI 10.​1007/​s12471-016-0921-8
To the Editor,
We recently published a study in which we showed that acute aortic dissection (AAD) is often initially missed, which was contributable to the absence of a typical clinical profile [1]. In addition to our findings, Siniorakis and colleagues stress the importance of fever as an often overlooked sign of AAD.
The body temperature on admission was not incorporated in our database, as such we cannot give information on this topic with regards to our cohort. Following the scarce literature we agree, however, with the points stressed by Siniorakis. Indeed, data from the International Registry of Acute Aortic Dissections (IRAD) have shown that fever was an independent predictor of a delayed diagnosis, with a median time from admission to diagnosis of 32 vs. 4 h [2]. Although fever is usually an inflammatory response to the dissection itself, it may also precede AAD in the rare case of complicated aortitis.
It is important for physicians in the emergency care department to be aware that fever may be a sign of AAD, which should not distract from the important diagnostic work-up for AAD.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Metagegevens
Titel
Aortic dissection, a diagnostic challenge
Auteurs
W. W. Jansen Klomp
A. P. Nierich
A. W. J. van ’t Hof
Publicatiedatum
25-07-2017
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 9/2017
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-017-1026-8

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