Aortitis

Abstract

A ortitis is the all-encompassing term ascribed to inflam- mation of the aorta.The most common causes of aortitis are the large-vessel vasculitides giant cell arteritis (GCA) and Takayasu arteritis, although it also is associated with several other rheumatologic diseases.Infectious aortitis is a rare but potentially life-threatening disorder.In some cases, aortitis is an incidental finding at the time of histopathological examination after surgery for aortic aneurysm.Because the clinical presentation of aortitis is highly variable, the cardiovascular clinician must have a high index of suspicion to establish an accurate diagnosis of this disorder in a timely fashion.Here, we review the pathophysiology, epidemiology, diagnostic approach, and management of aortitis. Pathophysiology and ClassificationAortitis is the pathological term for inflammation of the aortic wall.The classification of aortitis broadly includes underlying rheumatologic and infectious diseases, along with isolated aortitis (Table 1).The most common rheumatologic causes of aortitis are the large-vessel vasculitides GCA and Takayasu arteritis, although aortitis also is associated with systemic lupus erythematosus, rheumatoid arthritis, the HLA-B27associated spondyloarthropathies, anti-neutrophil cytoplasmic antibody-associated vasculitides, Behçet disease, Cogan syndrome, and sarcoidosis.Infectious causes include tuberculosis, syphilis, salmonella, and other bacteria.Aortitis also may occur in isolation (ie, no associated rheumatologic or infectious disease is present) or accompany idiopathic retroperitoneal fibrosis or an inflamed abdominal aortic aneurysm.