Silent Total Dissection Of the Descending Aorta

To the Editor.— Dissecting aneurysms of the aorta usually occur with pain or neurologic deficits, or both. 1,2 While silent dissections are uncommon, 2 their recognition has been facilitated by the advent of angiography. We report herein an unusual case of dissecting aortic aneurysm. The patient was completely asymptomatic with a silent dissection extending from the left subclavian artery to the aortic bifurcation. The case illustrates the importance of angiograms to demonstrate apparently localized aneurysms. Report of a Case.— A 46-year-old white man was admitted when a routine x-ray film of the chest showed dilatation of the aortic arch. An x-ray film of the chest taken five years earlier had similar, less prominent changes. He had been involved in a rapid-deceleration aircraft accident seven years previously sustaining trauma to the anterior chest. He did not recall severe chest, back, or abdominal pain at that time. There was no history of