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Aortitis with multiple aneurysms mimicking infective endocarditis
J P Veinot1, J W Lorimer, V M Walley
1Department of Laboratory Medicine, Ottawa Hospital, Ontario. Jpveinot@civich.ottawa.on.ca
The Canadian Journal of Cardiology
|February 20, 1999
Summary
Aortitis can cause aortic insufficiency and rare valvular masses. This case highlights complex complications including aneurysms, embolic events, and fatal aspergillus infection following treatment.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Infectious Diseases
Background:
- Aortitis, inflammation of the aorta, typically leads to aortic insufficiency via aortic root dilation.
- Valvular insufficiency from aortitis is rare, usually occurring when inflammation directly affects aortic valve cusps.
Observation:
- This report details a unique patient case involving aortitis.
- The patient presented with valvular masses, aortic and peripheral arterial aneurysms, embolic phenomena, and aortic insufficiency.
Findings:
- Surgical valve replacement, initially for suspected infective endocarditis, resulted in homograft dehiscence and multiple false aneurysms.
- Immunosuppressive therapy effectively reduced vasculitis but led to a severe opportunistic aspergillus infection.
Implications:
- This case underscores the complex and potentially severe manifestations of aortitis beyond aortic root dilation.
- It highlights the critical balance between managing autoimmune vasculitis and preventing opportunistic infections in immunocompromised patients.
- The case emphasizes the challenges in managing complications arising from both the primary disease and its treatment.