Reviewed By: Pramod Kerkar, MD, FFARCSI

What is Aortitis?

Aortitis is considered a general term by which is meant inflammation of the aorta. Aorta is a huge blood vessel that transports blood from your heart to your body. The aortic root is that portion of the aorta that is directly linked to the left chamber of your heart. The blood flows from the aorta via its vital branches, such as the subclavian arteries to your arms, the carotid arteries to your head and through the other branches to organs, such as the spleen, bowel, and the kidneys. Aortitis is generally a rare and life-threatening condition. Aortitis can cause stenosis resulting in lessened blood flow besides widening of the aorta, thus, causing the aorta to rupture. According to reports, there are only one to three novice cases of aortitis each year per million individuals in Europe and the US. It has been discovered that this problem is commonly found in people of 10-40 years old.

Symptoms of Aortitis

There are many symptoms of aortitis, but unfortunately, none is particular to this disorder and they are commonly linked with other disorders. Numerous patients show absolutely no symptoms during the initial stages of this problem. So, it is not uncommon to discover that the inflammation of the aorta is only known at the time of the surgical operation for an aneurysm. A few symptoms which are noted comprise fever, abdominal pain, back pain, shortness of breath, and chest pain. Again, other symptoms might include arm weakness, leg weakness, fatigue, dizziness, light-headedness, headaches, and fainting. A test may disclose abnormal blood pressure that includes both high and low, unusual heart sounds, a difference in blood pressure between your both arms, the absence of the pulse in your wrists, at times, in ankles, and anaemia.

Causes of Aortitis

Aortitis can occur due to a numbers of reasons. Some instances are ‘isolated' aortitis. This means that the aorta is inflamed despite any recognizably related disease. This problem can happen in the form of an isolated idiopathic problem of the aorta. A kind of aortitis influencing tissues that surrounds the aorta can happen along with a disease named retroperitoneal fibrosis. Other reasons are rheumatic diseases that include different types of vasculitis and infections. Again, non-infectious reasons of aortitis are types of large vessel vasculitis, commonly Takayasu arteritis and giant cell arteritis. The other autoimmune disorders related to aortitis comprise spondyloarthritis, rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, relapsing polychondritis, Behçet disease, Cogan syndrome, and ANCA related vasculitis. The infectious reasons of aortitis comprise tuberculosis, syphilis, and different bacterial infections.

Treatment for Aortitis

The treatment of Aortitis is dependent on its underlying cause. The infections can be managed with the help of antibiotic agents that are ideal for the recognized cause. When the case is of isolated aortitis and aortitis related with other rheumatic disorders and other kinds of vasculitis, it is vital to get the inflammation under regulation. Treatments comprise glucocorticosteroids, generally prednisone, and cytotoxic medications, such as azathioprine, methotrexate, and cyclophosphamide. In some instances, biologics, such as anti-tumor necrosis factor medications like rituximab and infliximab have been utilized. Isolated aortitis happening with retroperitoneal fibrosis can be treated with tamoxifen, which is an anti-estrogen medication and is known to get some success. At times, surgery is required for repairing a widened, weak aorta or for relieving blocked arteries. The care of aortitis needs periodic surveillance of the large arteries and aorta. Expert vascular surgeons and vasculitis experts are the main doctors in the multi-specialty care team. At times, regular visits and follow-up imaging of the aorta and the heart might be required.

Complications of Aortitis

The aortic root's aortitis can result in heart failure. Again, inflammation of the aorta plus its important arteries can result in weakness of the legs and arms with use, stroke, heart attack, and kidney failure. Treatment connected complications comprise side effects of prednisone, like weight gain because of increased appetite, lessened immune response causing infections more like, slower wound healing, augmented blood pressure, menstrual and hormonal cycle changes, and emotional fluctuations. The side effects of the medicines can comprise anaemia, an augmented danger of infections, and cancer too!

Conclusion

Patients suffering from aortitis ought to be reviewed regularly and it involves close monitoring of inflammatory markers, vascular signs, and imaging studies for monitoring treatment. The signs for surgical correction tend to be similar to other aneurysms. The occurrence of aortitis secondary to GCA might be underestimated as it isn't systematically considered in every patient with a vasculitis and aortitis aneurysm. It can leave with severe results, particularly considering that GCA is controllable and curable.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: December 4, 2018

This article does not provide medical advice. See disclaimer

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