Is your aorta inflamed? Let's talk about aortitis!

Have you ever thought that even the largest blood vessel in our body can have problems? Sometimes, the pain we feel for no apparent reason, or the discomfort we feel in our body, can sometimes be a sign of something like this. Today we are going to talk about aortitis, a condition that can occur in the aorta, the main blood vessel in our body.

What is aortitis? Let's understand it very simply.

Simply put, aortitis is an inflammation of your aorta . Now think about what this aorta is. It is the largest artery in our body. It is like the main water pipe that supplies water to our house. It is this aorta that branches out and supplies oxygen-rich, clean blood to every organ and tissue in our body. So, since this aorta is also a blood vessel, we can see this condition called aortitis as one aspect of vasculitis , or inflammation of blood vessels.

Sometimes, aortitis can be limited to the aorta. Or, it can occur along with inflammation of other blood vessels in the body (called systemic vasculitis). There are many types of systemic vasculitis. Doctors diagnose these based on which blood vessels are affected and what other symptoms they have.

Aortitis can cause your aorta to widen. We call it an aortic aneurysm . Or, the aorta can narrow. This is called aortic stenosis . Both of these conditions can be life-threatening . Because the aorta is the main artery that carries oxygen-rich blood throughout our body. If there is a problem with it, it affects the entire body system.

The symptoms you experience, how you are diagnosed, and the treatment options you receive depend on several factors:

• Which part of your aorta is affected by this condition .
• Whether there is inflammation in other blood vessels as well.
• Whether the doctor has identified an underlying cause or related disease.

Is Aortitis an autoimmune disease?

Yes, most doctors consider vasculitis (inflammation of the blood vessels) to be an autoimmune disorder . This is when your body's own immune system attacks its own tissues, causing inflammation. It's like setting your own house on fire.

How common is this condition called aortitis?

How common aortitis is depends on the underlying condition or cause. That is, whether it is associated with another disease or not. Generally speaking, aortitis is not a very common condition .

What are the symptoms of Aortitis?

The symptoms of aortitis can vary from person to person. It depends on whether it is caused by an underlying condition called vasculitis or another inflammatory or infectious disease. Sometimes, people with aortitis may not have any symptoms at all . That's what makes it a little scary.

However, here are some common symptoms:

• Chest pain: Imagine a sudden, squeezing or stabbing pain in your chest.
• Stomach pain (abdominal pain): Pain can occur in the lower abdomen, chest, or throughout the abdomen.
• Back pain: Pain, especially in the upper back.
• Headache : Not like a normal headache, but a slightly severe, persistent headache.
• Vision changes: Blurred vision or sudden loss of vision.
• Fever: The body becomes hot and feverish for no reason.
• Shortness of breath: Feeling like you are having trouble breathing even when you are slightly tired.
• Swelling of the legs: The ankles of both legs swell.
• Pain in the limbs (when using): Pain occurs when moving an arm or leg or doing work.
• Symptoms related to inflammation: fatigue, weight loss, loss of appetite, etc.
• Symptoms related to vasculitis affecting other blood vessels.
• Symptoms related to an underlying disease (if any).

What other effects can aortitis have on my body?

In addition to the symptoms, people with aortitis can develop various complications. These are very serious :

• Kidney failure: This can happen if the veins that supply blood to the kidneys are affected.
• Stroke: If there is a problem with the blood vessels that supply blood to the brain.
• Heart attack: If there is a problem with the arteries that supply blood to the heart.
• Heart failure: The heart is unable to function properly.
• Rupture or tearing of the aorta: This is the most dangerous. If the aorta ruptures, it is difficult to save your life.

What are the causes of Aortitis?

There are several main causes of aortitis. It may be part of an underlying condition called systemic vasculitis (inflammation that affects the blood vessels throughout the body). Or it may be related to another inflammatory disease. In these cases, the exact cause of the underlying disease and the associated aortitis is not yet known . In addition, some infections can also cause aortitis.

Sometimes, when performing surgery on the aorta, aortitis can be discovered unexpectedly. In this way, aortitis that is limited to the aorta, without any other underlying disease or inflammation of other blood vessels, is called "isolated focal aortitis."

Systemic vasculitis and other inflammatory diseases

Some of the diseases that can cause aortitis are:

• Giant cell arteritis: This is a condition that usually affects the arteries of the head and neck, usually in people over the age of 50.
• Takayasu arteritis: This is a disease that affects the aorta and its major branches, most commonly in young women.
• Cogan syndrome: A rare disease that affects the eyes and ears and can cause aortitis.
• Behçet's disease: A disease that causes sores in the mouth and genital area, skin problems, and inflammation of the eyes.
• Kawasaki disease: This is a disease that mostly affects young children . It causes inflammation of the blood vessels.
• Polyarteritis nodosa: A disease that affects medium-sized arteries.
• Other types of `systemic vasculitis`.
• Ankylosing spondylitis: A disease that causes inflammation of the joints of the spine.
• Rheumatoid arthritis: A well-known disease that causes joint inflammation.
• Systemic lupus erythematosus (SLE): An autoimmune disease that affects various parts of the body.
• Relapsing polychondritis: A disease that affects cartilage tissue.
• Sarcoidosis: A disease that causes small inflammatory nodules (granulomas) in various organs of the body.
• Immunoglobulin 4 (IgG4)-related disease: A fibrous and inflammatory condition that affects various organs.
• Inflammatory bowel diseases: such as Crohn's disease and ulcerative colitis.

Infections

Some severe infections can also cause aortitis. Some examples include:

• Salmonella: A bacteria that causes food poisoning.
• Syphilis: A sexually transmitted disease.
• Staphylococcus: A bacteria that causes skin infections and other serious infections.
• Rocky Mountain spotted fever: A tick-borne disease.
• Gonococcal infection: Gonorrhea.
• Tuberculosis: A bacterial infection that mainly affects the lungs.
• Hepatitis B and C: Viral infections that affect the liver.
• Herpes viruses:
• Fungal infections:

How is Aortitis diagnosed?

To know for sure if you have aortitis, your doctor will follow these steps:

• They will talk about your medical history: they will ask about your previous illnesses, your family's illnesses, and the medications you take.
• A physical examination will be performed: Your body will be examined.
• Imaging tests are ordered: tests that can get a better look at your aorta and its major branches.
• Blood tests are ordered: These can check the level of inflammation in your body.
• If you have had surgery involving the aorta, a tissue sample taken at that time will be examined under a microscope.

What tests are used to diagnose Aortitis?

Imaging tests:

• Echocardiogram: A test to look at the function and structure of the heart.
• Transesophageal echocardiogram: This is also an echo test, but a small instrument is passed through the esophagus to view the heart and aorta more clearly.
• Abdominal ultrasound: View the aorta in the abdomen.
• Computed tomography (CT) scan: A CT scan takes cross-sectional images of the body and provides detailed views of the aorta and surrounding tissues.
• Magnetic resonance imaging (MRI): Uses magnetic fields and radio waves to produce detailed images.
• Positron emission tomography (PET) scan: Helps identify areas of inflammation in the body.

Blood tests:

• Erythrocyte sedimentation rate (ESR): A test that indicates inflammation in the body.
• C-reactive protein (CRP): This is another important test that indicates inflammation.
• Complete blood count: This measures the types of cells in the blood and their numbers.
• Chemistries that test kidney and liver function:
• If necessary, other specialized blood tests to detect systemic vasculitis, other inflammatory diseases, or infections.

Aortic tissue examination:

If you are having surgery for an aortic aneurysm , your surgeon may take a tissue sample during the operation to check for inflammation. Some people are diagnosed with aortitis during this type of surgery, without having any previous symptoms.

How is Aortitis treated?

Aortitis can be treated with medication and/or surgery . Doctors will decide on treatment based on the following factors:

• Which part of your aorta is affected ?
• Whether an aneurysm or narrowing has occurred due to aortitis, and how serious it is .
• Whether there is an associated disease or other underlying cause .
• Whether it affects other blood vessels as well .

The important thing is that if you have "isolated focal aortitis" (meaning it's limited to the aorta, with no other cause) and have had surgery to completely remove it, and there's no underlying disease, you may not need further treatment. However, it's important to continue to be monitored by your doctor . If any new symptoms develop, you may need to be treated differently.

What are the medications used for Aortitis?

If your doctor diagnoses an underlying active systemic vasculitis condition, another inflammatory disease, or infection, they may prescribe medications such as:

• Anti-inflammatory or immunosuppressive medications: For systemic vasculitis or other underlying inflammatory conditions. These immunosuppressive medicines work by suppressing the body's immune system.
• Antibiotic drugs: If aortitis has developed due to an infection.

Are there any side effects to these treatments?

Yes, especially immunosuppressive medicines can reduce your body's ability to fight infections. Therefore, your doctor will explain the risks and benefits of each treatment to you. He will also talk to you about ways to reduce these risks. Don't be afraid, talk to your doctor and understand everything.

When is surgery necessary for aortitis?

You may need surgery in these cases:

• If you have an aortic aneurysm, if it feels large enough to burst, or if the aneurysm is affecting the functioning of the heart.
• If your aorta is narrowing, causing severe reduction in blood supply to vital organs.

How can I reduce this risk?

In most cases, aortitis is difficult to prevent because it can be associated with systemic vasculitis, an underlying inflammatory disease, a single inflammatory process, or an infection.

However, for people with aortitis, it is very important to reduce other risk factors for damage to the blood vessels . These include:

• Controlling high blood pressure.
• Lowering cholesterol levels.
• Complete cessation of the use of tobacco products.
• Exercising regularly.
• Maintaining a healthy weight for you.

If I have aortitis, who should be on my healthcare team?

Because aortitis can present in many different ways and require different treatments, you may need several healthcare providers to help you. For example:

• Primary care provider: A person who takes care of your general health.
• Cardiologist: A specialist in the heart and arteries.
• Rheumatologist: A specialist in joint, muscle, and autoimmune diseases, as many vasculitis conditions fall into this category.
• Infectious disease expert: If an infection is suspected.
• Cardiothoracic or vascular surgeon: If surgery is needed.

What is the outlook for aortitis?

How you experience aortitis depends on several factors:

• What part of your aorta is affected and how severe it is .
• Whether aortitis causes complications .
• Whether there is an associated disease or other underlying cause .
• The response to treatment (if treatment is needed) and whether the treatment causes any side effects .

How do I take care of myself?

The most important thing is to attend all follow-up appointments with your doctor, take your medications exactly as prescribed, and let your doctor know right away if you experience any new symptoms or discomfort. Don't panic, the most important thing is to pay attention to your body.

When should I see my doctor?

Your doctor will tell you how often you should see your doctor or have tests. If you develop new symptoms or old symptoms return, contact your doctor immediately.

When should I go to the Emergency Department (ETU) ?

The most dangerous complication of an aortic aneurysm is its rupture or bursting. This is a very serious condition, because your aorta is the main artery that carries a large amount of blood to your body. If you have any of these symptoms, it could be a ruptured aorta:

* If you suddenly experience severe pain in your chest, back, or abdomen (belly) without any warning.

* If the heartbeat is fast.

* If you feel dizzy.

* If you experience weakness or numbness in the face, arm, or leg, or difficulty speaking or seeing.

If you are taking immunosuppressive medicines for aortitis, or if you have an underlying systemic vasculitis or inflammatory disease, you may develop other serious complications that require immediate medical attention. Your doctor will explain to you which symptoms require you to go to the emergency room, based on your specific diagnosis and management plan.

What questions should I ask my doctor?

When you see your doctor, don't hesitate to ask questions like these:

• Can an underlying disease or cause be found for my aortitis?
• What is the best treatment plan for me?
• How does the doctor monitor my condition?
• Do I need to see other specialists?
• What symptoms should I look out for?

Finally, things to remember (Take-Home Message)

Because aortitis can be a life-threatening condition, it is important to continue to seek treatment from a healthcare professional who is knowledgeable about aortitis and its causes . You will need regular medical checkups to monitor your aorta. This may include doctor visits, blood tests, and imaging tests.

Understanding your specific aortitis concerns, being aware of the symptoms of serious complications, and knowing where to go for help when you need it will help you manage your aortitis situation. Face this with courage and without fear. You are not alone.

` Aortitis, Aorta, Inflammation, Heart Disease, Blood Vessels, Chest Pain, Aortic Aneurysm, Vasculitis