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Aortitis ˌā-ˌȯr-ˈtīt-əs

By John W. Hallett, Jr., MD, Clinical Professor, Division of Vascular Surgery, Medical University of South Carolina

Aortitis is inflammation of the aorta.

The aorta is the largest artery of the body. It receives oxygen-rich blood from the heart and distributes it to the body through smaller arteries that branch off of it. The inflammation sometimes causes an aneurysm or blockage (occlusion) of the aorta.

Aortitis is caused by

  • Connective tissue and vasculitis disorders, such as Takayasu arteritis, giant cell arteritis, ankylosing spondylitis, or relapsing polychondritis

  • Infections, such as bacterial endocarditis, syphilis, Rocky Mountain spotted fever, and fungal infections

  • Cogan syndrome (inflammatory of the cornea of the eye, hearing and balance problems, and inflammation of the aorta)

Inflammation usually involves all layers of the aorta and may lead to blockage of the aorta or its branches or weakening of the arterial wall, resulting in aneurysms.

Symptoms vary according to the cause and the site of aortitis and can range from back or abdominal pain with fever to severe shortness of breath and swelling of the legs (heart failure) if the aortitis affects the aortic valve of the heart. Some people experience aortic dissection or rupture, which can be fatal.

Diagnosis is made by imaging tests, such as computed tomography (CT) angiography, magnetic resonance angiography, or ultrasonography showing swollen and thickened areas of the aorta.

Blood tests that show increased levels of inflammation in the body (elevated C-reactive protein level, elevated erythrocyte sedimentation rate) can support a diagnosis of aortitis.

Treatment differs depending on the cause of the inflammation, for example, antibiotics if infection is the cause or anti-inflammatory or immunosuppressive drugs if connective tissue or vasculitic disorders are the cause. If the aortitis has caused irreversible damage, surgery or placement of a stent-graft may be necessary.