Aortic

Aortic - inflammation of the walls of the aorta. Most often aortic develops when syphilis, streptococcal infections, rheumatism, allergic processes, the system collagenoses. The disease is chronic, manifested by pain in the chest, expansion of the aorta. Prevention and treatment are reduced to the active therapy of the main disease.

Aortic (aortitis) - inflammation of the aorta, usually infectious origin. The main cause of Arteta is syphilitic infection; less frequent strep, fever, sepsis, tuberculosis aortic. Sometimes the aorta involved in inflammation of neighboring organs (tuberculosis, mediastinum). Described isolated cases of ortica when the system obliterans. Listed forms of ortica distinct clinical picture does not have. A. I suspect, when against the background of rheumatic, septic or another disease is determined by the expansion of the aorta.
A. refers to the late manifestations of syphilis. The first clinical symptoms A. occur several years after infection, much more often in men. The main clinical symptom of Arteta is a pain. Patients usually complain of long dull pressure and aching pain in the chest, increased physical activity, excitement. With the defeat of the mouths of the coronary arteries and failure aortic valve pain can take severe angina character.
Syphilitic aortic divided into uncomplicated and complicated (narrowing of the mouths of coronary artery disease, aortic insufficiency, aneurysm). For uncomplicated syphilis A. objective data is scarce. Sometimes it is possible to note the strong surge of aorta in the jugular fossa, percussion in the upper part of the sternum is the expansion of the aorta. When listening in II intercostal space to the right of the sternum is characterized by changes of the second tone, acquiring clear metal in nature. Often in the same place are heard soft systolic murmur, unlike rough systolic noise when aortic stenosis. Often systolic noise A. syphilis occurs or enhanced by show of hands (symptom Serotinin). With the defeat of the waste from the aortic arch large vessels occurs difference in intensity pulsing both carotid arteries, heart rate and altitude blood pressure on the right and left hands. Electrocardiogram is usually unchanged. Positive Wasserman observed in 74-95% of patients with syphilis by Artiom. The most important for the diagnosis of syphilis A. careful x-ray examination (x-ray, teleroentgenography, rentgenografiya and electrotomography, contrast aortography). Characterized by the expansion of the aorta, the increase of the amplitude of its pulsations, uneven paths and strengthening the shadow of the aorta.
Complications of syphilis Arteta narrowing the mouths of the coronary arteries or aortic insufficiency develops the picture slowly progressive chronic coronary insufficiency, followed cardiosclerosis and circulatory failure. The differential diagnosis spend with atherosclerosis of the aorta (see Arteriosclerosis), atherosclerotic cardiosclerosis (see), subacute septic endocarditis (see), tumors of the mediastinum (see).
The prognosis for syphilitic artice depends on the activity and the distribution process, the presence of complications. Prevention and treatment are reduced to active full treatment of syphilis. Treatment in a hospital environment, starting with the preparations bismuth, mercury, iodine and active penicillin therapy (see Syphilis, treatment). In severe coronary insufficiency, cardiac insufficiency protevoepilepticescoe treatment should be more cautious, combining it with effective koronarorasshiryayuschee therapy, cardiac glycosides, saluretiki funds, oxygenotherapy [see angina, Circulatory failure)]. C. Soloviev.
Pathological anatomy. The term " aortic" is designated as an inflammatory process in the aortic wall, primarily infectious nature and reactive changes in the aorta immunoallergical nature, by its morphological picture reminiscent of inflammation. Localization process distinguish Antartic, masorti, periaortic and panormic, but isolated defeat intima or adventitia are very rare (brucellosis, rheumatism). Distribution Arteta may be diffuse, ascending and descending.
Infectious aortic - private manifestation of the underlying disease (syphilis, rheumatism, pneumonia, malaria, brucellosis, gonorrhea, and so on). Occur more often masorti and panormic. In acute infectious A. (septic, streptococcal, gonorrhea, ricketsiosis, malaria) the aorta swollen, malolactic. Microscopically shell of its infiltrated by polymorphonuclear leukocytes. In chronic infectious artitech (syphilis, rheumatism, tuberculosis) aortic wall sealed, unbreakable, with calcification. Dating thickened, wrinkled, with abundant deposits of lime (A. syphilis), sometimes with the formation of folds type "valves" (rheumatic A.). Adventitia spotted sharply worthwhile. Microscopically in an intim rheumatic artice defined focus muhidnova swelling, fibrinoidnogo necrosis in the media - the phenomenon of metachromatic swelling, occasionally found rheumatic granuloma. For syphilis A. characteristic multiple foci of necrosis breaks elastic fibers, from lymphoid infiltrates, plasma, gistiotitarnaya cells and vast fields sclerosis. The microscopic picture of brucellosis and chronic fibrous rheumatic Arteta different from that indicated by the absence of plasma cells in the infiltrates. Characteristic of tuberculosis, syphilis and actinomycetaceae A. is the presence in adventitia specific granulomas.
To immunoallergical are the so-called youth and giant cell "aorta". First seen in young people, mostly women. Pathogenesis and etiology of the disease is not clear, the term "aortic" - here purely conventional. Characterized process, mainly affecting the ascending part of the thoracic aorta. The aortic wall diffuse thickened, resilient, sometimes with dense calcified adventitia. Microscopically - the uneven development of the connective tissue under the endothelium, swelling and fragmentation of elastic membranes with the deposition here lipoid and from lymphoid infiltrates and plasma cells. Often in the aortic wall observed necrosis type microinfarction. In adventitia amid sclerosis abundance vasa vasorum, or obliteriruushih all over, or with a vast proliferation of their endothelium. The defeat of the ascending aorta cover its branches with the development of the clinical picture disease "the absence of pulse " (Takayasu's disease).
Giant cell "Artic", or idiopathic necrosis media aorta, accompanied aneurysmal extensions and breaks its walls. The process begins as rheumatic aortic, with focal limfoadenopatiey infiltration of adventitia mixed with giant cell type Langhans. Infiltrates penetrate in media where there are foci of necrosis, surrounded by giant cells. The final stage of the process - fibrosis all shells aorta and the development of secondary atherosclerosis.