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CMAJ : Canadian Medical Association... Feb 2023
Topics: Humans; Aortitis; Drug Therapy
PubMed: 36849171
DOI: 10.1503/cmaj.220584-f -
IDCases 2021Corona Virus Disease of 2019 (COVID-19) pandemic has affected more than 67.9 million individuals world-wide and led to more than 15.5 million Deaths. In the initial...
Corona Virus Disease of 2019 (COVID-19) pandemic has affected more than 67.9 million individuals world-wide and led to more than 15.5 million Deaths. In the initial studies from China, 88.7 % of the patient were noted to have fever, 67 % of the patient had cough and 56.4 % had ground glass changes on the chest imaging. With time, the presentation of patients has been found to be highly variable and unpredictable. COVID-19 is reported to present with various complications, ranging from gastrointestinal (GI) manifestations, such as loss of sensation of taste, abdominal pain, diarrhea, vomiting, pancreatitis and hepatobiliary disease, to neurological manifestations of encephalitis and stroke, and cardiovascular manifestations like myocarditis, heart failure and arrythmia. We report a rare case of COVID-19 presenting with abdominal pain from aortitis.
PubMed: 33723505
DOI: 10.1016/j.idcr.2021.e01063 -
Annals of Thoracic and Cardiovascular... Dec 2018Patients with aortitis often present with nonspecific constitutional symptoms. Due to the fact that aortitis is associated with inflammatory or infectious courses,... (Review)
Review
Patients with aortitis often present with nonspecific constitutional symptoms. Due to the fact that aortitis is associated with inflammatory or infectious courses, patients may manifest fever or fever of unknown origin. Such clinical characteristics of aortitis are unavoidably brought about diagnostic dilemmas and might lead to a series of unnecessary work-ups and maltreatment. Therefore, it is important for the clinical physicians and surgeons to understand aortitis presenting with fever of unknown origin to avoid delayed diagnosis and treatment. In this article, clinical and pathological features of aortitis (giant cell arteritis, Takayasu arteritis and infective aortitis, etc.) with fever of unknown origin are described and the differential diagnosis and management policy are discussed.
Topics: Aortitis; Biopsy; Diagnosis, Differential; Fever of Unknown Origin; Humans; Predictive Value of Tests; Prognosis
PubMed: 30158332
DOI: 10.5761/atcs.ra.18-00136 -
Trends in Cardiovascular Medicine Nov 2019Inflammation affects the aortic wall through complex pathways that alter its biomechanical structure and cellular composition. Inflammatory processes that predominantly... (Review)
Review
Inflammation affects the aortic wall through complex pathways that alter its biomechanical structure and cellular composition. Inflammatory processes that predominantly affect the intima cause occlusive disease whereas medial inflammation and degeneration cause aneurysm formation. Aortic inflammatory pathways share common metabolic features that can be localized by smart contrast agents and radiolabelled positron emission tomography (PET) tracers. F-Fluorodeoxyglucose (F-FDG) is a non-specific marker of metabolism and has been widely used to study aortic inflammation in various diseased aortic states. Although useful in detecting disease, F-FDG has yet to demonstrate a reliable link between vessel wall disease and clinical progression. F-Sodium fluoride (F-NaF) is a promising biological tracer that detects microcalcification related to active disease and cellular necrosis within the vessel wall. F-NaF shows a high affinity to bind to diseased arterial tissue irrespective of the underlying inflammatory process. In abdominal aortic aneurysms, F-NaF PET/CT predicts increased rates of growth and important clinical end-points, such as rupture or the requirement for repair. Much work remains to be done to bridge the gap between detecting aortic inflammation in at-risk individuals and predicting adverse clinical events. Novel radiotracers may hold the key to improve our understanding of vessel wall biology and how this relates to patients. Combined with established clinical and morphological assessment techniques, PET imaging promises to improve disease detection and clinical risk stratification.
Topics: Aortic Aneurysm; Aortitis; Fluorodeoxyglucose F18; Humans; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Prognosis; Radiopharmaceuticals; Sodium Fluoride
PubMed: 30611605
DOI: 10.1016/j.tcm.2018.12.003 -
Journal of Vascular Surgery Jan 2021
Topics: Aortitis; COVID-19; Humans; Ischemia; SARS-CoV-2; Vasculitis
PubMed: 32889075
DOI: 10.1016/j.jvs.2020.08.029 -
JACC. Cardiovascular Imaging Jun 2014Multimodality imaging of aortitis is useful for identification of acute and chronic mural changes due to inflammation, edema, and fibrosis, as well as characterization... (Review)
Review
Multimodality imaging of aortitis is useful for identification of acute and chronic mural changes due to inflammation, edema, and fibrosis, as well as characterization of structural luminal changes including aneurysm and stenosis or occlusion. Identification of related complications such as dissection, hematoma, ulceration, rupture, and thrombosis is also important. Imaging is often vital for obtaining specific diagnoses (i.e., Takayasu arteritis) or is used adjunctively in atypical cases (i.e., giant cell arteritis). The extent of disease is established at baseline, with associated therapeutic and prognostic implications. Imaging of aortitis may be useful for screening, routine follow up, and evaluation of treatment response in certain clinical settings. Localization of disease activity and structural abnormality is useful for guiding biopsy or surgical revascularization or repair. In this review, we discuss the available imaging modalities for diagnosis and management of the spectrum of aortitis disorders that cardiovascular physicians should be familiar with for facilitating optimal patient care.
Topics: Aortitis; Carotid Artery Diseases; Diagnosis, Differential; Diagnostic Imaging; Echocardiography, Transesophageal; Giant Cell Arteritis; Heart Diseases; Hematoma; Humans; Magnetic Resonance Imaging; Positron-Emission Tomography; Takayasu Arteritis; Tomography, X-Ray Computed
PubMed: 24925329
DOI: 10.1016/j.jcmg.2014.04.002 -
VASA. Zeitschrift Fur Gefasskrankheiten Jan 2016Inflammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci... (Review)
Review
Inflammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci or septicaemia and tend to result in the rapid development of aneurysms. Large vessel vasculitis due to Takayasu arteritis in younger and giant cell arteritis (GCA) in older patients is located in all layers of the aortic wall and prevails in the thoracic section. GCA patients are prone to developing aortic complications in the late course of disease. In Behçet's disease, aneurysms may have an unusual morphology and localisation. The diagnosis of aortitis is usually obtained by vascular imaging, but partly made only by biopsy on occasion of an operation, especially in case of isolated aortitis of the ascending aorta which mostly remains inapparent until dissection or large aneurysms have developed. Periaortitis typically occurs in the abdominal aorta and may lead to inflammatory aortic aneurysm (IAA). It is looked upon as a special form of vasculitis, with an overlap to primary retroperitoneal fibrosis (RF). An identical pathology is discussed for the three diseases. On the other hand, about 50% of isolated aortitides and periaortitides as well as retroperitoneal fibroses can be classed among IgG4-related diseases. Periaortitis also is observed after treatment of aortic aneurysms by stent-graft implantation. Special attention should be paid to ureteral obstruction along with RF or IAA. Once infection is ruled out, immunosuppression is applied to all forms of inflammatory aortic diseases, primarily with glucocorticoids. However, after successful surgery for isolated thoracic aortitis or inflammatory aortic aneurysm immunosuppression may be dispensable and it is not required if periaortic tissue enlargement persists in chronic inactive disease. For some patients with periaortitis and RF, tamoxifen may be a valuable alternative.
Topics: Aged; Anti-Inflammatory Agents; Aortitis; Aortography; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Predictive Value of Tests; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler, Color; Vascular Surgical Procedures
PubMed: 26986706
DOI: 10.1024/0301-1526/a000491 -
Internal Medicine (Tokyo, Japan) Oct 2020
PubMed: 32611963
DOI: 10.2169/internalmedicine.4770-20 -
Frontiers in Cardiovascular Medicine 2022Aortic insufficiency is commonly observed in rheumatologic diseases such as ankylosing spondylitis, systemic lupus erythematosus, antiphospholipid syndrome, Behçet's... (Review)
Review
Aortic insufficiency is commonly observed in rheumatologic diseases such as ankylosing spondylitis, systemic lupus erythematosus, antiphospholipid syndrome, Behçet's disease, granulomatosis with polyangiitis, and Takayasu arteritis. Aortic insufficiency with an underlying rheumatologic disease may be caused by a primary valve pathology (leaflet destruction, prolapse or restriction), annular dilatation due to associated aortitis or a combination of both. Early recognition of characteristic valve and aorta morphology on cardiac imaging has both diagnostic and prognostic importance. Currently, echocardiography remains the primary diagnostic tool for aortic insufficiency. Complementary use of computed tomography, cardiac magnetic resonance imaging and positron emission tomography in these systemic conditions may augment the assessment of underlying mechanism, disease severity and identification of relevant non-valvular/extracardiac pathology. We aim to review common rheumatologic diseases associated with aortic insufficiency and describe their imaging findings that have been reported in the literature.
PubMed: 35497991
DOI: 10.3389/fcvm.2022.874242 -
European Journal of Case Reports in... 2021Aortitis is seen in a wide variety of diseases. It was rarely found in the past but this is changing because of new imaging techniques.
INTRODUCTION
Aortitis is seen in a wide variety of diseases. It was rarely found in the past but this is changing because of new imaging techniques.
CASE DESCRIPTION
We present the case of a 45-year-old man who was found on thyroid ultrasound to have infrarenal aortitis and pathological lymphadenopathies in different locations. After an exhaustive diagnostic process, tuberculous aortitis, an infrequent manifestation of extrapulmonary tuberculosis, was diagnosed. The condition resolved after a 6-month course of antibiotics and a 6-week course of corticosteroids.
CONCLUSION
Tuberculous aortitis is an atypical manifestation of Mycobacterium tuberculosis infection. The absence of typical symptoms and the difficulty of isolating the microorganism makes its diagnosis difficult. Therefore, clinical suspicion, microbiological tests and imaging are key for reaching the diagnosis and starting treatment for a serious disease that can cause aortic aneurysm and dissection.
LEARNING POINTS
New imaging techniques can identify aortitis for the diagnosis of extrapulmonary infection.The extrapulmonary manifestations of infection are diverse and include aortitis.Prompt and accurate differentiation between infectious and non-infectious causes of aortitis determines which of two very different therapeutic paths should be followed and hence the prognosis of the patient.
PubMed: 34377690
DOI: 10.12890/2021_002598