What Is Aortitis?

Aorticitis

Aorticitis

Aorticitis

Aortic inflammation is an inflammatory disease of the aortic wall and can be caused by several pathological processes. Such as Takayasu arteritis (so-called pulsation), syphilis, arteriosclerosis, dissecting aneurysms, and so on.

About half of the patients present with systemic illness at the onset of fatigue, fever, night sweats, weight loss, joint pain, and fatigue. Often anemia and erythrocyte sedimentation are significantly elevated. The performance at this stage gradually disappeared, followed by a more chronic stage, showing occlusive changes in inflammation of the aorta and its branches. The other half showed only late vascular changes and no previous systemic disease. In the later stages of the disease, the weakened arterial wall results in a localized aneurysm.

The blood vessels of the aortic arch are particularly vulnerable. Any one or even all branches are closed. Fainting and transient cerebral ischemia (TIA) can occur when carotid and vertebrobasilar arteries are involved, as well as intermittent movement disorders of the lower jaw (chewing or speech) and upper limbs. Facial and upper limb muscle atrophy, and visual impairment are also common. Occlusive thoracic occlusion of the descending aorta sometimes results in acquired aortic constriction. Although the aortic arch is most commonly affected, the abdominal aorta (especially the renal artery) can also be damaged, causing severe renal vascular hypertension. Heart failure is not uncommon and can be caused by severe hypertension, impaired coronary arteries, or aortic valve insufficiency caused by the disease. Pulmonary arterial occlusion causes rare pulmonary hypertension.

Physical examination typically found that the pulse on the side of the aortic arch was significantly weakened or pulseless, and blood pressure was reduced or undetectable. Unless there is an acquired aortic constriction, these pulses are clearly contrasted with lower limb pulsations, and the patient's true blood pressure can be measured from the lower limbs. Noise can be heard on some narrowed arteries. Anastomosis of arteriovenous rings can be seen in the fundus of 25% of patients.

Prognosis and treatment

Many patients with Takayasu's arteritis do not cause significant complications in the end. These patients can live well for many years. The 5-year survival rate of patients without major complications is 95%. Those with important complications such as stroke, myocardial infarction, severe hypertension, heart failure, and aneurysms have a 5-year survival rate of 50% to 70%.

The symptoms of acute arteritis are often alleviated with corticosteroids: usually prednisone is 60 to 100 mg per day until the symptoms are eliminated, and then the drug is gradually reduced as soon as possible, although the total course of treatment may take several months. Those who are resistant to corticosteroids can add cyclophosphamide orally at 2 mg / kg per day, and the white blood cells should be kept above 3000 / l during treatment. Some data suggest that the early-stage vascular complications of corticosteroids and cyclophosphamide in the acute phase may be less. People with ischemia suggest using anticoagulants or platelet inhibitors such as warfarin, that is, 325mg of aspirin per day. Hypertension should be actively treated. Because hypertension is often renal vascular, angiotensin-converting enzyme inhibitors can be particularly effective.

The disease's advanced surgery plays an important role in rebuilding blood flow to occluded arteries. Balloon angioplasty in selective patients can temporarily improve the patient. Aneurysms of arteries and aorta may require surgical removal.

Traditional Chinese medicine treatment is based on nourishing yin, clearing heat, promoting blood circulation, and removing blood stasis. The habitat, gypsum, matrimony, calamus, red cockroach, salamander, antelope horn, ghost arrow feather salvia, etc. are commonly used drugs, with few adverse reactions Safe and effective. If there are blood clots, some blood circulation and dispersing drugs such as pangolin, pangolin, earth dragon, leeches, turmeric, etc. should be used.