Type B aortic dissection in a chronic haemodialysis patient.

A 61-year-old African-American patient presented to the emergency room with severe back pain. The patient had a history of end-stage renal disease on haemodialysis for 6 years, chronic obstructive lung disease and uncontrolled hypertension. CT scan revealed type B aortic dissection extending from the left subclavian artery to the right renal artery (figures 1⇓–3). There were no signs or symptoms of malperfusion. The patient was medically managed; blood pressure control required four different classes of antihypertensive drugs. It should be noted that the patient had consistently refused antihypertensive treatment previously. …