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Giant cell arteritis presenting with annuloaortic ectasia
Gabriella Nesi1, Chiara Anichini, Elena Pedemonte
1Department of Pathology, University of Florence, Florence, Italy.
Insights
Giant cell arteritis can cause severe aortic regurgitation due to ascending aorta aneurysms. This condition may be the initial presentation of Horton disease or linked to prior temporal arteritis or polymyalgia rheumatica.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Inflammation
Background:
- Giant cell arteritis (GCA), also known as Horton disease, is a systemic vasculitis.
- Aortic involvement in GCA, while recognized, can manifest in various ways.
- Ascending aortic aneurysms are a potential, though less common, complication.
Observation:
- The study details four cases where GCA led to severe aortic regurgitation.
- The aortic pathology was secondary to an aneurysm of the ascending aorta.
- Clinical history of temporal arteritis or polymyalgia rheumatica was present in two patients.
Findings:
- In two cases, the aortic disease was the initial clinical manifestation of Horton disease.
- This highlights that cardiothoracic symptoms can be the first sign of GCA.
- The link between GCA and ascending aortic aneurysms causing severe aortic regurgitation is demonstrated.
Implications:
- Early recognition of GCA is crucial, even when presenting with cardiac symptoms.
- Cardiothoracic evaluation should be considered in patients with suspected GCA.
- Understanding these presentations can improve diagnostic timelines and patient outcomes in GCA.
Abstract:
Four cases of giant cell arteritis causing severe aortic regurgitation secondary to an aneurysm of the ascending aorta are described. In two cases, the nature of the aortic pathology could be suspected considering the past clinical evidence of temporal arteritis and/or polymyalgia rheumatica. In the two other cases, the cardiothoracic manifestations represented the onset of Horton disease.