A Palpatory Sign of Dissecting Aneurysm

To the Editor:—  Since effective surgical measures have been developed to manage the patient with dissecting aortic aneurysm, it is no longer a lesion of mere academic interest. However, definitive surgery depends upon accurate and speedy diagnosis, and this is frequently difficult to achieve. An aneurysm arising in the proximal aorta may present classical findings by producing aortic insufficiency and changes in the character of the head and arm vessels. Physical findings in the patient with an aneurysm at or beyond the origin of the left subclavian artery may be scanty and obscure. Nor are aortography or other x-ray techniques exclusively and consistently of diagnostic value. There is need for a single, sure, diagnostic method. The sign hereinafter described is not offered as a sine qua non of dissecting aneurysm. However, since its chance discovery some ten years ago it has been observed in every patient (12) seen by the