J Cardiovasc Ultrasound.  2010 Dec;18(4):165-168. 10.4250/jcu.2010.18.4.165.

A Case of Idiopathic Aortitis Mimicking Severe Aortic Stenosis

• Lee SH
• Choi JH

• KMID: 2177322
• DOI: http://doi.org/10.4250/jcu.2010.18.4.165

Abstract

Aortitis is the all-encompassing pathological term ascribed to inflammation of the aorta. Regardless of the etiology, it frequently results in aortic root dilatation and aortic insufficiency rather than aortic stenosis. The rare case of aortitis such as isolated idiopathic aortitis may occur without evidence of systenic inflammatory disease or infection, and usually has subclinical nature. Even though the goals of therapy include immediate treatment of aortic inflammation or infection, the optimal management of isolated idiopathic aortitis is uncertain. We report a rare case of isolated idiopathic aortitis mimicking acute severe aortic stenosis, which was improved after steroid therapy.

Keyword

Aortitis; Aortic stenosis; Inflammation

MeSH Terms

Aorta
Aortic Valve Stenosis
Aortitis
Dilatation
Inflammation

Figure

• 

  Fig. 1 Parasternal long axis (A) and short axis views (B) reveal swollen aortic valve (AV) leaflets (arrow) and markedly narrowed AV area. These morphological changes result in severe stenotic physiology of AV with a mean transvalvular gradient of 48 mmHg and peak transvalvular aortic pressure of 79 mmHg (C). LV: left ventricle, LA: left atrium, RV: right ventricle, RA: right atrium.

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  Fig. 2 Aortic valve (AV) long axis view demonstrates severe swelling of aortic root (arrows) and periaortic apparatus more clearly (A). AV short axis view shows narrowed AV orifice (B). LV: left ventricle, LA: left atrium, RV: right ventricle, RA: right atrium.

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  Fig. 3 Both of coronal (A) and sagittal views (B) show increased uptake of fluorine-18-fluorodeoxyglucose in the aortic arch (arrow head), but not in the aortic valve (arrow). LV: left ventricle.

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  Fig. 4 In follow up transthorasic echocardiography, parasternal long axis (A) and short axis views (B) demonstrate decreased thickness of aortic leaflet and aortic root wall. Also, peak and mean pressure gradients of aortic valve are improved and measured as 31.6 and 16.0 mmHg, respectively (C). LV: left ventricle, LA: left atrium, RA: right atrium.

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