1/20. giant cell arteritis presenting with annuloaortic ectasia.Four cases of giant cell arteritis causing severe aortic regurgitation secondary to an aneurysm of the ascending aorta are described. In two cases, the nature of the aortic pathology could be suspected considering the past clinical evidence of temporal arteritis and/or polymyalgia rheumatica. In the two other cases, the cardiothoracic manifestations represented the onset of Horton disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/20. Aortic root replacement with a stentless bioprosthesis in a patient with giant cell arteritis.A 66-year-old woman was diagnosed with severe aortic regurgitation. blood studies constantly showed positive c-reactive protein. aortic valve replacement using a mechanical valve was carried out. Four months after the operation, echocardiogram showed aortic regurgitation due to paravalvular leakage. reoperation was performed using a stentless aortic root bioprosthesis. The pathological specimen from the aortic wall was consistent with giant cell arteritis. The patient was treated with prednisone with dramatic improvement of systemic symptoms.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
3/20. giant cell arteritis in a patient with acute aortic insufficiency with thyrotoxicosis.Acute aortic insufficiency in the setting of thyrotoxicosis can mask the presentation of vasculitis. We report a case of a 38-year-old woman with a 22 weeks gestation pregnancy who was known to be hyperthyroid for 4 months prior to conception. She presented with thyrotoxicosis and acute respiratory failure. Echocardiogram revealed severe acute aortic regurgitant flow. Following medical treatment for aortic insufficiency and thyrotoxicosis, the patient underwent ascending aorta replacement with aortic valve repair. Pathological exam revealed giant cell arteritis. Both giant cell arteritis and thyrotoxicosis share a common major histocompatibility antigen which may facilitate concomitant disease presentation. Following immunosuppression for giant cell arteritis, valve repair, and treatment for thyrotoxicosis, the patient made a complete recovery. A rise in human chorionic gonadotropin (HCG) during the first trimester of pregnancy is known to have a stimulatory effect on the thyroid gland and may result in hyperthyroidism. Although HCG may have exacerbated the existing hyperthyroidism, in this case it was not causal, as the diagnosis preceded her pregnancy by several months. diagnosis of vasculitis may be overshadowed by the presence of thyrotoxicosis. Significant vascular compromise in the setting of thyrotoxicosis must prompt an evaluation for vasculitis. This may prevent unnecessary surgery with attendant morbidity and mortality.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
4/20. Giant aneurysms of the sinuses of Valsalva and aortic regurgitation in a patient with Noonan's syndrome.Noonan's syndrome is one of the commonest hereditary syndromes with cardiac involvement. We report a rare presentation of this syndrome, associated with giant aneurysms of the left and non-coronary sinuses of Valsalva, resulting in symptomatic aortic valve regurgitation. The patient's clinical investigations and operative management are presented. Histological examination of aortic tissues offers insight into the pathogenesis of these complications.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/20. Cartilaginous and osseous metaplasia with bone marrow formation in the aortic valve of a patient with giant cell aortitis.We describe the case of a 40-year-old man who presented with an ascending aortic aneurysm and aortic valve regurgitation. The patient underwent a Bentall surgical procedure. Pathologic findings were consistent with giant cell aortitis with synchronous cartilaginous and osseous metaplasia with bone marrow formation in the degenerated aortic valve. The coexistence of these findings has not been previously reported in the English language literature.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
6/20. Aortic root dilation secondary to giant cell aortitis in a human immunodeficiency virus-positive patient.hiv-associated vasculitis rarely involves the aorta. There is no well-established association of hiv and giant cell arteritis. We present the case of a 31-year-old hiv positive Indian woman who was referred to us with complaints of dyspnea and chest pain. physical examination revealed a diastolic murmur in the aortic area and echocardiography showed a dilated aortic root causing severe aortic regurgitation. She was being adequately treated with anti-hiv therapy. She underwent aortic valve and root replacement and the histopathological findings of the aortic specimen showed giant cell arteritis.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
7/20. Granulomatous aortic valvulitis associated with aortic insufficiency in Takayasu aortitis.We report an unusual case of Takayasu aortitis associated with a giant cell granulomatous valvulitis presenting with aortic insufficiency. Although nonspecific valvular abnormalities have been reported with Takayasu aortitis, this case is the first to describe involvement of the aortic valve by the disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/20. Two-dimensional and Doppler echocardiographic findings in a case of subaortic "fibrous sac".We described a 37-year-old man with a subaortic "fibrous sac", admitted for congestive heart failure. On 2-dimensional echocardiography a saccular structure was seen to extend from the left coronary cusp of the aortic valve to the outflow tract of the left ventricle. By color Doppler imaging, a grade 3 aortic regurgitation was recognized. Aortic regurgitant flow was recorded from the left coronary cusp to the saccular lesion. When congestive heart failure became exacerbated, the repeat examination showed the regurgitant flow passing through the perforated bottom of this lesion and reaching the left ventricular cavity. On microscopic examination of the excised valve, capillary proliferation and inflammatory changes were recognized near the annular region of the left coronary cusp. The edge of the valve leaflet and the other 2 cusps were intact. It is likely that our patient had a mycotic aneurysm near the aortic ring. We speculate that aortic regurgitation followed inflammation. It dilated the left ventricular cavity and contributed to congestive heart failure. inflammation also weakened the tissue near the annulus, causing it to protrude into the subaortic region thus forming a small aneurysm. It may have grown to become a large saccular structure under high aortic pressure. That is, it became a "giant" endocardial pocket with inflammatory process. Finally, the rupture of this sac caused a massive aortic regurgitation, exacerbating congestive heart failure.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/20. Severe aortic regurgitation as a late complication of temporal arteritis.Two patients with a remote history of pathologically documented giant cell arteritis developed severe regurgitation. The first patient developed severe aortic regurgitation five years after the pathologic documentation of giant cell arteritis of the temporal arteries. giant cell arteritis involvement of the aortic root was confirmed. The second patient developed aortic regurgitation seven years after pathologic documentation of giant cell arteries of the temporal arteries. Although pathologic confirmation of the aortic root process was not obtained, this case strengthens the clinical association between giant cell arteritis of the temporal arteries and subsequent aortic root dilatation and severe aortic regurgitation. observation for signs of de novo severe aortic regurgitation is indicated in follow-up of patients with temporal arteritis.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/20. Aortic regurgitation caused by giant cell aortitis.A case of giant cell aortitis causing aortic regurgitation is reported. The aortic valve was replaced with a Medtronic-Hall prosthesis. The patient has been followed for seven months, during which time she received steroid therapy. There was good evidence of hemodynamic correction, but no evidence of further progress in the arteritis has been noted. The pathological and clinical problems of this disease are discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
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