Aortitis

Aortitis
Classification and external resources
Specialty	cardiology
ICD-10	I77.6
ICD-9-CM	447.6
eMedicine	med/158
MeSH	D001025

Aortitis is the inflammation of the aortic wall. The disorder is potentially life-threatening and rare. It is reported that there are only 1-3 new cases of aortitis per year per million people in the United States and Europe.^[1] Aortitis is most common in people 10 to 40 years of age.^[1]

Causes

This inflammation has a number of possible causes, including trauma, viral or bacterial infections (notably, syphilis), and certain immune disorders and connective tissue diseases.^[1]

Aortitis is most commonly seen in patients with syphilis, autoimmune vasculitis, giant cell arteritis, Takayasu's arteritis and rheumatoid arthritis.^[2] IgG4-related disease is a more recently identified cause of aortitis and periaortitis.^[3]

There is a wide range of symptoms that are dependent on the location of the aortic inflammation or associated disorder. A few symptoms recognized in patients are fever, chills, muscle pains, and malaise (general discomfort).^[2] In addition, hypertension (high blood pressure) may occur. Hypertension happens when the renal artery narrows and elasticity of the aorta and branches decrease.^[4]

Treatment

Treatment of aortitis depends on the underlying cause.^[5] Infectious causes commonly require antibiotic treatment, while those associated with autoimmune vasculitides are generally treated with steroids.

Management includes the following treatment priorities: stop the inflammation, treat complications, prevent and monitor for re-occurrence.

Prognosis

If untreated, has three distinct phases.^[1] The first is a prepulseless inflammatory stage with nonspecific symptoms such as fatigue, arthralgias, and low-grade fevers. Phase two includes vascular inflammation with pain secondary to the condition, along with tenderness to palpation over the site. The last phase includes symptoms of ischemia and pain associated with the use of limbs. Limbs are also cool and clammy in this stage.

References

1 2 3 4 "eMedicine - Aortitis : Article by Masato Okada, MD, FACP, FACR, FAAAAI". Archived from the original on 14 July 2007. Retrieved 2007-07-28.
1 2 [Taber's Cyclopedic Medical Dictionary. 19th ed. Philadelphia: F.A. Davis, 2001.]
↑ John H. Stone, Arezou Khosroshahi, Vikram Deshpande; et al. (October 2012). "Recommendations for the nomenclature of IgG4-related disease and its individual organ system manifestations". Arthritis & Rheumatism 64 (10): 3061–3067. doi:10.1002/art.34593. PMID 22736240.
↑ Link text, American Heart Association.
↑ Gornik, H. L.; Creager, M. A. (2008). "Aortitis". Circulation 117 (23): 3039–51. doi:10.1161/CIRCULATIONAHA.107.760686. PMC 2759760. PMID 18541754.

Arteries, arterioles
and capillaries

Inflammation

Arterial occlusive disease /
peripheral artery disease

Arteriosclerosis	Atherosclerosis Foam cell Fatty streak Atheroma Intermittent claudication Critical limb ischemia Monckeberg's arteriosclerosis Arteriolosclerosis Hyaline Hyperplastic Cholesterol LDL Oxycholesterol Trans fat

Stenosis	Carotid artery stenosis Renal artery stenosis

Other	Aortoiliac occlusive disease Degos disease Erythromelalgia Fibromuscular dysplasia Raynaud's phenomenon

Aneurysm / dissection /
pseudoaneurysm

Vascular malformation

Vascular nevus

Veins

Inflammation	Phlebitis

Venous thrombosis / Thrombophlebitis	primarily lower limb Deep vein thrombosis abdomen Hepatic veno-occlusive disease Budd–Chiari syndrome May–Thurner syndrome Portal vein thrombosis Renal vein thrombosis upper limb / torso Mondor's disease Paget–Schroetter disease head Cerebral venous sinus thrombosis Post-thrombotic syndrome

Varicose veins	Gastric varices Portacaval anastomosis Caput medusae Esophageal varices Hemorrhoid Varicocele

Other	Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer

Arteries or veins

Blood pressure

Hypertension	Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension

Hypotension	Orthostatic hypotension

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