A 72-year-old women with polymyalgia rheumatica clinically controlled on maintenance steroid therapy presented with symptoms of chest pain and numbness in the right arm. A diagnosis of dissecting aortic aneurysm was confirmed at thoracotomy and the aorta was successfully resected. Histology revealed active giant cell aortitis. We suggest that a normal erythrocyte sedimentation rate in patients with treated temporal arteritis does not preclude large vessel involvement.
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