What Is Aortitis?

What Causes Aortitis?

The causes of aortitis are classified into three types:

• Noninfectious Causes: Examples of noninfectious causes of aortitis are:
  • Rheumatic disease (inflammatory disorders that cause chronic pain of the joints, muscles and connective tissue), including:
    • Giant cell arteritis (GCA)
    • Takayasu’s arteritis
    • Behcet’s syndrome
    • Cogan’s syndrome
  • Other inflammatory disorders, including:
    • Systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis and sarcoidosis
• Infectious Causes: Certain types infections can lead to aortitis, including tuberculosis, salmonella, syphilis, Rocky Mountain spotted fever, herpes virus, and hepatitis B and hepatitis C.
• Isolated aortitis: When the aortitis does not have an identifiable underlying cause it is called isolated aortitis.

Aortitis Symptoms

Aortitis symptoms may vary based on the location and cause of the inflammation. Some people with aortitis may not experience any symptoms. General symptoms of the condition include:

• Chest pain
• Backpain
• Abdominal pain
• Headache
• Shortness of breath
• Vision changes
• Fever
• Swelling in the legs
• Pain in the arms or legs with use
• Symptoms of inflammation, including decreased energy, loss of appetite or weight loss
• Symptoms associated with vasculitis that affects other blood vessels
• Symptoms associated with an underlying disease

Complications of Aortitis

Inflammation of the aorta and its major branch arteries can lead to aortic aneurysm, kidney failure, heart failure, heart attack and stroke. In cases where an underlying disease or infection is the cause of the aortitis, complications are related to that specific cause.

Diagnosis of Aortitis

To diagnosis aortitis, your healthcare provider will:

• Go over your medical history with you.
• Perform a physical exam.
• Order imaging tests to look at your aorta and its major branches.
• Order blood tests that can look for underlying conditions or infections, abnormal levels of inflammation, organ function and other indicators.
• Evaluate your aortic tissue under a microscope if you’ve undergone aortic surgery.

Imaging tests for aortitis may include:

• Computed tomography scan (CT): A CT scan creates cross-sectional images of the body using x-ray imaging technology.
• Magnetic resonance angiography (MRA): A type of magnetic resonance imaging, MRA is specifically designed to look at blood vessels.
• Aortic angiogram: This procedure uses a special dye and x-rays to see how blood flows through the aorta.
• Transesophageal echocardiography: In this test, an ultrasound probe is inserted through the esophagus to view aorta using high-frequency sound waves.
• Echocardiogram (Echo): This test uses ultrasonic waves to assess your heart’s structure and function. An echocardiogram often shows the location and severity of aortic coarctation. The test can also reveal other congenital heart defects, such as a bicuspid aortic valve.
• Positron emission tomography (PET): A PET scan is an imaging technique in which a small amount of a safe radioactive substance (radioactive tracer) is injected into the patient to help view and measure changes in blood flow and other physiological processes.
• Abdominal ultrasound: This non-invasive test uses high-frequency sound waves to view the aorta.

Aortitis Treatment

Treatment of aortitis depends on the cause of the inflammation. Infectious aortitis, though not common, can be life-threatening. As such, it requires swift treatment with antibiotics, sometimes administered intravenously.

In cases of isolated aortitis and aortitis associated with systemic vasculitis or other autoimmune disorders, the goal of treatment it to reduce and control the inflammation and prevent tissue damage, usually with corticosteroids such as prednisone. For aortitis caused by systemic vasculitis or another autoimmune condition, your doctor may also prescribe other medications such as immunosuppressant drugs or biologic medications.

Surgical repair or angioplasty may be necessary in aortitis patients with the following:

• Significant high blood pressure resulting from a narrowing of one or both of the arteries leading to the kidneys (renovascular stenosis)
• Myocardial ischemia (a condition in which a partial or complete blockage of a coronary artery obstructs blood flow to the heart muscle) secondary to coronary artery involvement
• Disabling claudication (pain in the legs or arms that occurs during walking or using the arms) that does not respond to other treatment methods
• Cerebral ischemia (insufficient blood flow to the brain)
• Significant aortic regurgitation (a condition in which the heart’s aortic valve does not close tightly, thereby causing blood to leak backward into the heart)
• Thoracic or abdominal aortic aneurysms larger than 5 centimeters in diameter