Currently, there are a huge number of diseases that can affect different organs and systems of the body. But among them there are those who prefer to choose representatives of a certain gender. In our article, we will get acquainted with one of such ailments - this is nonspecific aortoarteritis, from which the female sex most often suffers, and moreover, young age. The disease is most often diagnosed in Asian countries. Let's look at the causes of its occurrence, symptoms, and simultaneously discuss whether it is possible to cope with this pathology.
Essence of the disease
Nonspecific aortoarteritis is a rheumatic disease in which damage occurs to the inner surface of the arteries and their branches. If the inflammatory process progresses, then the walls of the vessels thicken, the smooth muscle layer begins to collapse and is replaced by connective tissue, and granulomas consisting of huge cells appear in the vessels.
As a result of such processes, the blood vessel expands and protrudes, and an aneurysm develops. If the process is not stopped, then everything ends with the death of elastic fibers of smooth muscle tissue. Organs and tissues begin to suffer due to impaired blood flow. In the international system of classification of diseases, each disease has its own code, nonspecific aortoarteritis is not an exception. ICD assigned him the code M31.4 (aortic arch syndrome).
Causes of the disease
To date, the reasons that provoke the development of this pathology have not been established. Most researchers who deal with this issue are of the opinion that infections, which lead to immunodeficiency states, play an important role in this. This opinion has arisen due to the fact that non-specific aortoarteritis is often combined with diseases, which are based on immune disorders.
There is currently a group of scientists who are leaning in favor of an autoimmune theory of the development of the disease. This is confirmed by the detection of anti-aortic antibodies in plasma patients.
We can say that the autoimmune mechanism of the disease can be confirmed, but whether it is primary or occurs in response to the inflammatory process is still difficult to say.
Disease classification
Non-specific aortoarteritis is of various types depending on the area of the lesion:
- The first type - in this case only the aortic arch and small branches that leave from it are affected.
- In the second type, arteries in the thoracic and abdominal regions are affected.
- The third type - the aortic arch is affected along with the thoracic and abdominal.
- The fourth is characterized by damage to the pulmonary artery.
Whatever scheme develops nonspecific aortoarteritis (Takayasu's disease), disability threatens patients very often. Especially if the diagnosis is too late.
Symptoms of the disease
Nonspecific aortoarteritis symptoms have various, it all depends on the form of the disease. Takayasu disease can have a chronic course and an acute phase.
The acute phase of the disease is manifested by the following symptoms:
- General fatigue.
- With physical exertion, pain in the muscles and joints appears.
- A hemorrhagic rash appears .
- Erythema nodosum develops.
- Cardiac borders expand.
- Systolic and sometimes diastolic murmur appears.
- Rarely, abdominal pain.
- If laboratory tests are performed, they show moderate anemia, the presence of C-reactive protein.
Quite often, with the onset of such symptoms, an erroneous diagnosis is made - "rheumatoid arthritis", "tuberculosis" or "sepsis". This, unfortunately, happens in 95% of cases.
The course of the chronic stage of the disease
If from the first stages of the development of the disease no effective measures are taken to cure it, then the pathology soon passes into the chronic stage. Symptoms are already different from those in the acute phase:
- There is practically no pulse on one arm, and sometimes on both.
- Patients often complain of pain in the limbs, which only increase when the load is increased.
- Hands become weak, people find it difficult to hold objects.
- Dizziness becomes frequent, which can result in loss of consciousness.
- When visiting an optometrist, a change in the fundus is detected.
- Since coronary arteries are often involved in the process, ischemic attacks can be observed.
- With damage to the abdominal aorta, kidneys begin to suffer.
- Neurological disorders appear in the form of impaired attention, memory, decreased performance.
- If the optic nerve is affected, then vision suffers, double vision appears, blindness in one eye may occur.
- Involvement of the pulmonary artery leads to the development of shortness of breath, chest pains appear.
- Hand joints suffer.
- With nonspecific aortoarteritis, the spread of the process begins with the main arteries, which, as a rule, leads to an increase in blood pressure due to narrowing of blood vessels.
Usually, the acute phase of the disease becomes chronic within 6-8 years. Patients should be wary if they are constantly tormented by weakness, headache, pain along the large arteries, impaired coordination and memory. A full examination is necessary to establish an accurate diagnosis.
Establishing diagnosis
If nonspecific aortoarteritis is suspected, early diagnosis is very important. This disease is recognized by doctors if the following symptoms are evident:
- If there is a significant difference in blood pressure in different hands.
- The pulse is greatly weakened or not felt at all.
- Intermittent claudication appears.
- When listening, there are noises in the aorta.
- Examination reveals a narrowing of the artery.
- Aortic valve insufficiency.
- Persistent increase in pressure.
- ESR increased for some reason.
The following studies will help to make a final diagnosis:
- A biochemical blood test will show abnormalities in the blood composition that are characteristic of this pathology.
- Ultrasound examination of blood vessels allows you to assess their condition and blood flow velocity.
- Angiography with the introduction of a contrast medium reveals the narrowing of the arteries.
- An x-ray of the chest determines the site of damage to the aorta and pulmonary artery.
- Echocardiography will evaluate the work of the heart.
- By means of electroencephalography, it is possible to detect abnormalities in the blood vessels of the brain.
Thus, for any disease, including such as non-specific aortoarteritis, the history of the disease begins with a full examination, the purpose of which is to make the correct diagnosis.
Differential diagnosis
When diagnosing, it is very important to differentiate aortoarteritis from congenital malformations of the vascular system and thromboembolism. The latter is characterized by acute course with the possibility of the formation of a blood clot in the cavity of the heart muscle.
An important distinguishing feature is that non-specific aortoarteritis affects groups of vessels, while certain arteries suffer from congenital anomalies.
If you rely on a diagnosis of renovascular arterial hypertension, you must remember that it can also develop with atherosclerosis of the renal vessels. If non-specific aortoarteritis develops mainly in young women, then atherosclerosis affects older men.
Only a full examination and a competent specialist will help to accurately diagnose and begin effective treatment.
Clinical syndromes during the pathology
Given that with this pathology, various sections of the vessels that supply blood to the internal organs can be affected, several clinical syndromes can be distinguished:
- Peripheral blood flow insufficiency syndrome. In this case, pain in the hands with a feeling of numbness of the fingers is observed. If the vertebral arteries are affected , then pain is present in the back.
- Cardiovascular syndrome - is associated with the development of collateral circulation. Signs of myocarditis, ischemia can be diagnosed.
- If the aortic arch is affected, then cerebrovascular syndrome develops. It manifests itself as headaches, decreased vision, impaired cerebral circulation.
- Abdominal syndrome is manifested by abdominal pain, which is paroxysmal in nature. This manifestation is not uncommon with damage to the abdominal aorta.
- Arterial hypertension syndrome - manifests itself as a result of renal artery damage.
Therapy
If a diagnosis of "nonspecific aortoarteritis" is made, the treatment is intended to:
- Significantly affect the focus of inflammation, possibly reducing it to a minimum.
- Fight ischemic complications.
- Remove the manifestations of arterial hypertension.
What to do if a person has nonspecific aortoarteritis? Diagnosis has been made, tests have been completed, the specialist’s task is to build a treatment regimen. Therapy may be as follows:
- Medication.
- Surgical intervention.
Consider the indications and features of each option.
Drug treatment
Medications for aortoarteritis are prescribed taking into account the severity of the patient's condition and the characteristics of the course of the inflammatory process. Most often, the following drugs are prescribed:
- "Prednisolone" in an amount of 1-2 mg per kilogram of patient weight. Reception is carried out for 1-2 months.
- If the inflammation is mild, then administration of aminoquinoline preparations, for example, Delagil 0.25 g, is indicated.
- Basic therapy is based on Methotrexate. The dosage is 7-10 mg per square meter of body surface. Reception - once a week.
- Ancillary drugs include anticoagulants, heart remedies, and medicines that lower blood pressure.
Drug therapy is long-lasting, if there are no improvements or pronounced disturbances in the functioning of the limbs, brain, it is recommended to resort to surgical intervention.
Surgery
If conservative methods of treatment do not help, and the situation only worsens, you will have to resort to the help of surgeons. Surgical intervention will help restore blood circulation to organs and tissues. But it must be borne in mind that before the operation, the inflammatory process must be stopped. There are several methods of this kind of therapy:
- Endarterectomy. It is performed in the presence of isolated segmental occlusions of arteries that depart directly from the aorta.
- Agnioplasty is performed if there are single changes in the vessels of the kidneys.
- Bypass surgery is performed using synthetic vascular prostheses. Such an intervention is effective for multiple vascular lesions.
After surgery, the rehabilitation period is important, following the doctor’s recommendations.
Recommendations for patients
We found out what non-specific aortoarteritis is, the symptoms and treatment were also considered, but for patients it is no less important to observe the following recommendations:
- Each patient should be aware that the treatment of this disease requires time and compliance with all doctor's prescriptions.
- It is necessary to adhere to the scheme and dosage of taking medications that the doctor advised.
- Since a large number of drugs are taken during therapy, there is a risk of developing various undesirable effects. To minimize them, you need to regularly undergo examination and take tests.
- If the condition worsens, it is necessary to inform the specialist.
If you adhere to these recommendations, then the treatment of the disease will be more successful.
Prognosis for patients
Unfortunately, it is impossible to completely get rid of nonspecific aortoarteritis, but with all the recommendations of the doctor and effective drug treatment, a stage of remission can be achieved. This will allow patients to engage in familiar activities and not experience pain.
The effectiveness of treatment depends on the severity of the inflammatory process and the presence of complications, and this is already affected by the accuracy and speed of diagnosis. In order for the result of therapy to be positive, it is necessary to detect the disease in the early stages.
No special preventive measures are provided.
Any disease requires a serious approach, the only way to improve the condition or even defeat the disease. Take care of your health and regularly undergo examinations - this way you can identify pathology in the early stages and choose an effective treatment.