Isolated Idiopathic Aortitis in a Young Female Presenting With Exertional Chest Pain: A Case Report

Aortitis is a general term that describes inflammation of the aorta. In most cases, this inflammation is caused by an autoimmune etiology or an infectious etiology. In some instances, the underlying etiology may not be clear, and the diagnosis given is idiopathic aortitis. Cases of idiopathic aortitis are usually diagnosed based on histopathologic findings. Here, we present a case involving a 31-year-old female presenting with acutely worsening exertional shortness of breath and left-sided chest pain. An echocardiogram revealed a severely reduced ejection fraction with severe aortic regurgitation and diffusely increased aortic intima-media thickness. Bioprosthetic aortic valve replacement was performed with histology, showing findings consistent with aortitis, and the patient received the diagnosis of idiopathic aortitis. This case highlights the need to consider aortitis as a differential in young patients presenting with exertional chest pain and severe aortic insufficiency.