Aortic dissection presenting as a febrile disease and atrial fibrillation

aortic dissection is a cardiovascular emergency. its main manifestation is severe chest pain, and approximately 50% of patients present with an elevated systemic blood pressure. rare reported physical findings include a pulsatile sterno-clavicular joint, dysphagia or testicular tenderness. the absence of sudden onset of pain lowers the likelihood of aortic dissection. we describe a patient in whom aortic dissection was accompanied by fever, nightsweats, suprasternal pain and atrial fibrillation.