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PubMedDate not supplied

Takayasu aortitis with acute dissection and hemopericardium.

We report a case of a 57-year-old woman with an unremarkable past medical history who presented to the emergency department with maxillary pain that later radiated to the chest. She died less than 12 h after admission. CT findings were consistent with ascending aorta dissection with hemopericardium. Autopsy revealed a tear immediately proximal to the ostium of the brachiocephalic artery and a dissecting flap with false lumen, rupture, and hemopericardium. Histologically, there was a zonal medial necrosis with surrounding chronic inflammation, focal destruction of the media, and fibrosis of the intima and adventitia. A diagnosis of granulomatous necrotizing aortitis of Takayasu type was made. This case demonstrates a rare example of aortitis underlying aortic dissection and emphasizes the need for careful histologic examination in cases of aortic root disease.

Aortic Dissection↗

PubMed2006

Behçet's aortitis mimicking aortic valve endocarditis with subaortic complications.

Behçet's disease is a systemic inflammatory disease with rare cardiac involvement. We present a case of Behçet's aortitis involving the aortic and mitral valves with vegetations resembling aortic valve endocarditis with subaortic complications. Recurrent aortitis after aortic valve replacement resulted in an aortic pseudoaneurysm formation with moderate perivalvular aortic regurgitation that stabilized with immunosuppressive therapy and without the need for additional cardiac operation.

Adult↗

PubMed2006

Pneumococcal aortitis: a difficult preoperative diagnosis.

Primary infections of the aorta are rare. We recently treated a patient who was given a diagnosis of noninfectious aortitis after an extensive work-up, but after clinical deterioration, was found to have a pneumococcal mycotic aneurysm at the time of surgery. The difficulty in distinguishing microbial aortitis from noninfectious chronic periaortitis is discussed as well as the need for frequent surveillance imaging of the aorta if immunosuppression is used to treat the latter entity. The infected aortoiliac segment was ultimately repaired with autologous femoral veins.

Aged↗

PubMed1989

Aneurysm in the sequestrated lung and aortitis associated with the malignant rheumatoid arthritis.

A scar phase of rheumatoid aortitis and aneurysms in the sequestrated lung with a lesion continuous to an aortic lesion was found in autopsy specimens from a 50 year-old-woman, who had suffered from generally disseminated carcinoma of the breast. The aorta revealed a scar phase of granulomatous panaortitis continuously from the ascending to the descending thoracic aorta. The media and adventitia of the aorta were largely replaced by scar tissue, although the aortic valve was spared. The systemic arteries in the sequestrated lung were destroyed completely by the necrotizing angiitis and showed saccular aneurysm filled with organizing fibrin thrombus. The pulmonary artery was intact. These findings suggest that the saccular aneurysm in the sequestrated lung was produced by necrotizing angiitis, in association with rheumatoid aortitis.

Aneurysm↗

PubMed1999

Cryptococcal aortitis presenting as a ruptured mycotic abdominal aortic aneurysm.

Mycotic processes occasionally complicate atherosclerotic aortic disease and usually require aggressive surgical therapy to control sepsis and prevent arterial rupture. Rarely, fungal organisms are responsible for primary infection of the abdominal aorta. We report the first case of Cryptococcal aortitis presenting as a ruptured abdominal aortic aneurysm. The surgical, pathologic, and microbiologic aspects of fungal aortitis are discussed.

Aneurysm, Infected↗

PubMedDate not supplied

Salmonella aortitis with pseudoaneurysm formation diagnosed by transesophageal echocardiography.

A case of Salmonella aortitis with pseudoaneurysm formation involving the descending thoracic aorta is described. Transesophageal echocardiography (TEE) was instrumental in establishing the diagnosis and leading to a successful surgical intervention. A high index of suspicion is required to make a timely diagnosis of Salmonella aortitis, and TEE should be considered in cases of possible thoracic involvement.

Aged↗

PubMed1997

Aortitis, aortic valve incompetence, and left coronary ostium stenosis in a patient with C-ANCA-associated necrotizing vasculitis.

Aortitis with involvement of the aortic valve is rarely associated with vasculitis syndromes. We present a patient with antibodies to a neutrophil cytoplasmic antigen-associated (ANCA) vasculitis with renal failure who developed aortic incompetence as a result of aortitis which involved the aortic valve. Thickening of the aortic wall also caused stenosis of the left coronary ostium.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed2001

An unusual case of vegetative aortitis diagnosed by transesophageal echocardiography.

We report a case of Staphylococcus aureus aortitis in a 42-year-old man who had a fever, an embolus to the left upper arm, and positive blood cultures. Transesophageal echocardiography re-vealed a 3 x 1-centimeter polypoid mass attached to the intima of the medial wall of the aorta, just distal to the origin of the left subclavian artery. The clinical presentation and the transesophageal echocardiography findings led to the diagnosis of vegetative aortitis. Antibiotic therapy was begun, and 5 days later the mass was surgically excised to prevent the possible formation of an infective aortic aneurysm and embolization to the vital organs.

Adult↗

PubMed1999

Aortitis due to Salmonella: report of 10 cases and comprehensive review of the literature.

We describe ten cases of aortitis due to Salmonella that were treated at the University of Toronto-affiliated Hospitals between 1978 and 1997. Predisposing conditions included hypertension, diabetes mellitus, and myelodysplastic syndrome. Main presenting symptoms were fever and abdominal and back pain. The most frequent site involved was the abdominal aorta, followed by the thoracic aorta. All but one patient were treated with intravenous bactericidal antibiotics; seven also underwent surgery, four with axillobifemoral grafts and three with in situ grafts. Four of seven patients died within 1 month of the surgical procedure (three patients with in situ grafts and one patient with axillobifemoral graft). We also reviewed the pathogenesis, clinical and laboratory characteristics, and treatment of 140 cases of aortitis due to Salmonella reported in the literature since 1948. The use of bactericidal antibiotics, together with early surgical intervention and long-term suppressive antibiotic therapy, has led to improved survival.

Adult↗

PubMed1998

Intracranial aneurysms associated with aortitis syndrome: case report and review of the literature.

OBJECTIVE AND IMPORTANCE: Aortitis syndrome is a systemic vasculitis of unknown etiology, affecting mainly the major branches of the aorta and leading to stenosis or occlusion. Intracranial aneurysms are rarely associated with this syndrome. Only 15 cases have been previously reported. CLINICAL PRESENTATION: A 54-year-old woman with a 10-year history of aortitis syndrome demonstrated nonruptured cerebral aneurysms in the left internal carotid and anterior communicating arteries, with decreased flow in the right internal carotid artery and ipsilateral A1 segment. INTERVENTION: The patient underwent clipping of the aneurysms through a left pterional craniotomy and transsylvian approach. CONCLUSION: In our review of 16 reported cases, including the present case (13 with ruptured aneurysms and 3 with nonruptured aneurysms), there were 25 saccular aneurysms, and we noted the following clinical characteristics: 1) patient age was 26 to 64 years, with an average of 50.2 years; 2) aneurysms arose predominantly along the course of collateral flow, especially in the vertebrobasilar system (13 of 25 aneurysms, 52.0%); 3) there was a high incidence of multiplicity (7 of 16 cases, 43.8%). These characteristics suggest that increased hemodynamic stress, produced by stenosis or occlusion of the major branches of the aorta and systemic hypertension, plays an important role in the development of cerebral aneurysms in patients with this syndrome.

Aortitis↗

PubMed1984

Distal aortitis complicating Reiter's syndrome.

Distal aortitis was diagnosed in a 44 year old man who had previously shown clinical features of Reiter's syndrome. This appears to be the first reported case of distal aortitis associated with Reiter's syndrome.

Adult↗

PubMed1985

Diffuse non-specific aortitis with multiple saccular aneurysms and aorto-enteric fistula.

A rare variant of non-specific aortitis was found at necropsy in a young hypertensive woman. The aorta showed severe, extensive, non-specific aortitis with multiple saccular aneurysms containing thrombi throughout its length except for 2 cm from its bifurcation. A fistulous tract was identified leading from an aortic aneurysm at the level of the renal arteries to the second part of the duodenum. Both renal artery ostia were narrowed. The small intestine contained 2 litres of blood, at necropsy. Bilateral ischaemic atrophy of the kidneys was present.

Adult↗

PubMed2001

Active aortitis in relapsing polychondritis.

Relapsing polychondritis (RP) is a rare inflammatory multiorgan disorder affecting cartilaginous structures and other connective tissues. Serious cardiovascular complications have been reported in patients with RP, the most frequent being aortic or mitral regurgitation and aortic aneurysms. Aortitis is a very rare complication. An unusual case of active aortitis in a patient with RP, despite intensive immunosuppressive treatment, is described with a special emphasis on the pathological findings.

Aorta↗

PubMed2001

Aortitis as a manifestation of myelodysplastic syndrome.

Aortitis is the inflammation of the wall of the aorta and can occur from an infection or autoimmune disease. Myelodysplastic syndrome (MDS) is characterised by abnormal haematopoiesis and a dysfunctional immune system. Autoimmune manifestations have been described in MDS. Here a case of a patient with aortitis and MDS is presented and discussed. All possible aetiologies were ruled out. The patient's symptoms resolved after she received steroids.

Aortitis↗

PubMed2002

Barking up the wrong tree? Use of polymerase chain reaction to diagnose syphilitic aortitis.

The presentation of syphilitic aortitis is often atypical and available serological tests are non-specific. The diagnostic gold standard remains direct identification of microorganisms in tissue. We present a case of syphilitic aortitis that presented as a mediastinal mass and report the use of polymerase chain reaction for Treponema pallidum to diagnose syphilitic aortic disease.

Aged↗

PubMed1996

Multiple congenital cardiac anomalies and idiopathic thoracic aortitis in a horse.

An echocardiographical and clinical pathological investigation of the rapid loss of weight by a yearling thoroughbred filly revealed an atrial septal defect, a ventricular septal defect and hyperfibrinogenaemia. A post mortem examination confirmed the cardiac abnormalities and revealed a severe thoracic aortitis. It is proposed that the idiopathic thoracic aortitis contributed to the horse's compromised cardiovascular homoeostasis.

Animals↗

PubMed1985

Effort angina without coronary obstruction in a patient with Takayasu's aortitis: a case report.

Angina occurring in patients with Takayasu's aortitis is attributed to the narrowing of the coronary ostium and/or aortic regurgitation. We treated a patient with Takayasu's aortitis with effort angina, in whom there was no obstruction of the ostium or aortic regurgitation. Treadmill exercise stress test revealed significant ST depression in leads V4-6, II, III and aVF with chest pain. Examinations of lactate in coronary sinus as well as arterial blood suggested the occurrence of myocardial ischemia during atrial pacing. The DPTI/TTI index was decreased and the left ventricular end-diastolic pressure was increased during angina. It is considered that the reduced coronary perfusion pressure resulted from a low diastolic aortic pressure and the elevated left ventricular end-diastolic pressure decreased the DPTI/TTI index and contributed to the development of subendocardial ischemia.

Adult↗

PubMed1986

Tuberculous aortitis presenting with an aortoduodenal fistula: a case report.

An elderly man with tuberculous aortitis presented with massive gastrointestinal bleeding resulting from an aortoduodenal fistula. Aortic resection was successful, and he has done well over a 12 year period. The organism was recovered from the aorta and also seen on section of the neighboring lymph nodes. Although tuberculous aortitis is rare, it should be considered in a patient with prior history of tuberculosis who has developed evidence of aortic disease, aneurysm, or massive gastrointestinal bleeding.

Aged↗