What is Aortitis
The aorta can be exposed to various inflammatory processes, these processes can cover the three layers of the wall of the aorta, and the condition in which is the patient is referred as aortitis. Aortitis can cause occlusion of the aorta affected by inflammation and weakness in the arterial wall and the formation of ballooning of a portion of an artery.
Symptoms of aortitis
In patients with aortitis following symptoms may occur: weakness, fever, weight loss, skin rash, vascular insufficiency, sweating especially at night, joint pain and fatigue. These difficulties in aortitis are also accompanied by increased sedimentation rate and anemia.
The initial phase of aortitis is leading to a new chronic condition that can be characterized by inflammation, and necrosis of walls of arteries and their branches. In the advanced stage of aortitis, comes to weaknesses of aortic wall and forming of a local aneurysms. Aortitis greatly affects the walls of the of the aortic arch, and because of aortitis, comes to narrowing and closing of the aorta. This patient’s condition caused by aortitis is called the aortic arch syndrome. Aortitis can cause loss of the consciousness, or due to a disorder of the blood circulation can lead to the transient ischemic attacks. Aortitis can lead to convulsions, mumbling, reduced muscle mass on face and hands and vision disorders.
Due to higher blood pressure heart failure may occur, but this is not often the case when it comes to the aortitis. Pulmonary hypertension in the aortitis can lead to obstruction of the pulmonary artery. Aotritis usually occur in patients with the biliary colic, rheumatologic diseases, Takayasu arteritis, giant cell arteritis, dental disease and other bacterial infections that can enter in the bloodstream.
Diagnosis of the aortitis
Diagnosis of the aortitis is based on the basis of history, physical examination and clinical picture. At physical examination of the aortitis, weak peripheral pulse appears, lowered and very hard to see blood pressure on aorta, which come from aortic arch. In aortitis the narrowing of the aorta may occur as well, that leads to a sharp rapid pulse.
This condition of aortitis requires determination of blood pressure and careful monitoring. For the diagnosis of aortitis this methods and instruments are used: x-ray for chest, angiography to see blood flow and existing narrowing, electrocardiogram for damage to the heart, blood test should indicate the presence of infection, angiography and MRA for inspection of blood circulation.
Treatment for the aortitis
Acute phase of aortitis can often be treated with corticosteroids. This therapy should be intensive until symptoms start to decrease, and sometimes, aortitis is treated with corticosteroids up to several months. Cyclophosphamide can be applied in patient who is suffering from aortitis and have resistance to the corticosteroids. Hypertension also must be treated aggressively, and particularlyACE inhibitors can be useful. Surgical treatment for aortitis is indispensable when you need to restore circulation in the places where has been a partial or complete arterial occlusion. This is achieved by endarterectomy or bypass . Angioplasty balloon may also be a useful tool in certain aortitis treatments. Occurring aneurysm demands resection.
Syphilitic aortitis (SA)
Syphilitic aortitis is very rare today, thanks to antibiotics. Syphilitic aortitis is implied with aortic spirochetes infection (caused by syphilis). There is possibility for further evolution of the aneurysm. For diagnostics are used the Waserman’s reactions and the Treponema pallidum immobilization test. Penicillin treatment is advised for syphilitic aortitis. If the aneurysm is expanding rapidly, or he is greater than 7 cm or symptomatic, replacement with graft is recommended.
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