Takayasu Arteritis Causing Aortitis and Aortic Regurgitation: A Totally Tubular Case Report

Boparai, Navdeep; Girgis, Mina; Kiamanesh, Omid; Al-Arnawoot, A.; Amad, Hani; Tsang, Wendy

doi:10.1016/j.case.2020.10.009

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Takayasu arteritis was the most frequent cause of aortitis leading to AR in our litera- [11]. In 3 cases of TA, presented by Hanna R, AR was registered only in one case [12].…”

Section: Resultsmentioning

confidence: 61%

“…Our patient has no signs of the spine immobility or any other sign of the longstanding AS. The absence of significant changes in the sacroiliac joints also ruled out the diagnosis of ankylosing spondylitis in our patient [10,11] A rare cause of aortitis is relapsing polychondritis (RP), a multisystem infl ammatory disease involving cartilage and connective tissue of various organs [6]. Heart and vessel lesions are observed in 25% of cases of RP, and aortitis, aortic aneurysms, aortic dissection and aortic and mitral regurgitation are the late complications of the disease.…”

Section: Resultsmentioning

confidence: 61%

“…Takayasu arteritis and giant cell arteritis, ankylosing spondylitis, relapsing polychondritis are the main causes of non-infectious aortoarteritis [3,4]. In our analysis of case reports from the literature search, the origin of the aortitis, leading to aortic regurgitation, was Takayasu arteritis (TA) in 5 cases, giant cell arteritis (GCA) in 2 cases, anлylosing spondylitis (AS) in 2 cases, relapsing polychondritis in 2 cases, sarcoidosis -in 1 case, COVID-19 -in 1 case, aortitis on non-specifi ed origin (idiopathic) in 2 cases [4,5,7,[10][11][12][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Resultsmentioning

confidence: 99%

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Aortoarteritis and Severe Aortic Insuffi Ciency in a Patient After Covid-19

Oryshchyn

Ivaniv²

2022

PSSS MS

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Aortoarteritis is a rare cause of the aortic insuffi ciency, but it should be considered among the other causes of aortic regurgitation. A number of cases of autoimmune aortoarteritis have been reported during the COVID-19 pandemic. We present a case report of aortoarteritis with severe aortic insuffi ciency, which developed in a patient after a mild form of coronavirus infection and an episode of arthritis. Echocardiography revealed severe aortic regurgitation, dilatation of the thoracic aorta and thickening of the aortic walls. Ultrasonography showed thickening of the carotid arterial walls. Computed tomography confi rmed the diagnosis of aortoarteritis. Elevated C-reactive protein indicated an acute infl ammatory process. Aortoarteritis was treated with methylprednisolone with good clinical response. Possible causes of aortoarteritis are discussed: Takayasu arteritis, giant cell arteritis, ankylosing spondylitis and polychondritis. After exclusion of all possible causes, aortoarteritis in the patient was diagnosed as an autoimmune process caused by coronavirus infection. Cases of arteritis in patients related to COVID-19 are discussed. Multimodality diagnostics (echocardiography, contrast-enhanced computed tomography, ultrasonography of aortic branches) play a central role in detecting aortic lesions and evaluating the extent of the pathological process in aortitis. A laboratory workup is needed to identify the cause of the aortitis. The fi nal diagnosis should be made on the analysis of clinical manifestations, diagnostic and laboratory fi ndings.

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“…Takayasu arteritis was the most frequent cause of aortitis leading to AR in our litera- [11]. In 3 cases of TA, presented by Hanna R, AR was registered only in one case [12].…”

Section: Resultsmentioning

confidence: 61%

Section: Resultsmentioning

confidence: 61%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Aortoarteritis and Severe Aortic Insuffi Ciency in a Patient After Covid-19

Oryshchyn

Ivaniv²

2022

PSSS MS

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“…Echocardiography may show normal aortic cusps and AI associated with root dilatation; however, there has been a case of aneurysm of the right sinus of Valsalva which developed 14 years after valve replacement in a Takayasu patient ( 63 ). Thickened aortic root and ascending aorta can be demonstrated on echocardiography, with complementary findings of diffuse wall thickening and gadolinium enhancement seen on CT and MRI, respectively ( 64 ). Cross sectional imaging studies should be used to evaluate the distal aorta and branch vessels that are not easily visualized on echocardiography.…”

Section: Takayasu Arteritismentioning

confidence: 99%

Multimodality Evaluation of Aortic Insufficiency and Aortitis in Rheumatologic Diseases

Choi

Mathews

Paik

et al. 2022

Front. Cardiovasc. Med.

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Aortic insufficiency is commonly observed in rheumatologic diseases such as ankylosing spondylitis, systemic lupus erythematosus, antiphospholipid syndrome, Behçet's disease, granulomatosis with polyangiitis, and Takayasu arteritis. Aortic insufficiency with an underlying rheumatologic disease may be caused by a primary valve pathology (leaflet destruction, prolapse or restriction), annular dilatation due to associated aortitis or a combination of both. Early recognition of characteristic valve and aorta morphology on cardiac imaging has both diagnostic and prognostic importance. Currently, echocardiography remains the primary diagnostic tool for aortic insufficiency. Complementary use of computed tomography, cardiac magnetic resonance imaging and positron emission tomography in these systemic conditions may augment the assessment of underlying mechanism, disease severity and identification of relevant non-valvular/extracardiac pathology. We aim to review common rheumatologic diseases associated with aortic insufficiency and describe their imaging findings that have been reported in the literature.

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“…This pathology can be subsequently classified depending on its etiology into inflammatory and infectious causes. Large-vessel vasculitis (giant-cell arteritis, Takayasu arteritis, and IgG4-related aortitis) is the most common non-infectious causes of aortitis, whereas syphilis and bacterial and mycobacterial infectious are the most common infectious etiologies worldwide [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Giant-Cell Aortitis-Induced Acute Aortic Insufficiency: An Underestimated Etiology

et al. 2022

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Rare coexistence of disease or pathology Background:Acute aortic insufficiency can be secondary to multiple conditions, including infective endocarditis, aortic root pathologies (eg, dissection, aortitis), or traumatic injury. Aortitis involves a broad spectrum of disorders characterized by inflammatory changes in the aortic wall. This pathology can be subsequently classified depending on its etiology into inflammatory and infectious causes. Large-vessel vasculitis (giant-cell arteritis, Takayasu arteritis, and IgG4-related vasculitis) is the most common non-infectious causes of aortitis. Giant-cell aortitis usually lacks the classic clinical findings of giant-cell arteritis such as headache, visual symptoms, or jaw claudication, which can be a diagnostic challenge. However, clinicians should have a high index of suspicion, since this pathology can evolve into potentially life-threatening conditions, including aortic aneurysm, aortic wall rupture, and aortic acute dissection. Case Report:We present a case of a 76-year-old woman who presented to the Emergency Department (ED) with shortness of breath associated with orthopnea, paroxysmal nocturnal dyspnea, and mild productive cough with white sputum. A transthoracic echocardiogram demonstrated reduced left ventricular ejection fraction, dilated left ventricle, and severe aortic insufficiency. Cardiac catheterization revealed mild non-obstructive coronary arteries and severe aortic regurgitation. The surgical pathology report of the portion of the aorta was consistent with giant-cell aortitis. Conclusions:In this article, we present a case of giant-cell aortitis as an unusual etiology of acute aortic insufficiency, which is most probably under-detected in clinical practice. In addition to describing the case, we aim to highlight the importance of proper ascending aorta evaluation in patients presenting with new-onset aortic regurgitation and heart failure to prevent associated morbidity and mortality.

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Takayasu Arteritis Causing Aortitis and Aortic Regurgitation: A Totally Tubular Case Report

Cited by 5 publications

References 13 publications

Aortoarteritis and Severe Aortic Insuffi Ciency in a Patient After Covid-19

Aortoarteritis and Severe Aortic Insuffi Ciency in a Patient After Covid-19

Multimodality Evaluation of Aortic Insufficiency and Aortitis in Rheumatologic Diseases

Giant-Cell Aortitis-Induced Acute Aortic Insufficiency: An Underestimated Etiology

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