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 sex. In our article, we will get acquainted with one of these ailments - this is nonspecific aortoarteritis, from which the female sex most often suffers, and at a young age. The disease is most often diagnosed in Asian countries. Let's look at the causes of its occurrence, symptoms, and along the way discuss whether it is possible to cope with this pathology.
Essence of disease
Non-specific aortoarteritis is a disease of a rheumatic nature, in which the inner surface of the arteries and their branches is affected. If the inflammatory process progresses, the walls of the vessels thicken, the smooth muscle layer begins to break down and is replaced by connective tissue, and granulomas appear in the vessels, consisting of huge cells.
As a result of such processes, the blood vessel expands and protrudes, 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 no exception. The ICD assigned him the code M31.4 (aortic arch syndrome).
Causes of disease development
To date, the causes that provoke the development of this pathology have not been established. Most researchers who deal with this issue are of the opinion that infections play an important role in this, which lead to immunodeficiency states. This opinion has developed due to the fact that nonspecific aortoarteritis is often combined with diseases based on immune disorders.
Currently there is a group of scientists who are leaning in favor of the autoimmune theory of the development of the disease. This is confirmed by the detection of anti-aortic antibodies in the plasma of patients.
It can be said that the autoimmune mechanism of the disease can be confirmed, but whether it is primary or occurs in response to an inflammatory process is still difficult to say.
Disease classification
Aortoarteritis nonspecific is of different types depending on the affected area:
- First type - in this case, only the aortic arch and small branches that extend from it are affected.
- The second type affects the arteries in the thoracic and abdominal regions.
- Third type - the aortic arch is affected along with the thoracic and abdominal regions.
- The fourth is characterized by damage to the pulmonary artery.
No matter what pattern nonspecific aortoarteritis (Takayasu's disease) develops, disability threatens patients very often. Especially if the diagnosis is made too late.
Symptoms of the disease
Non-specific aortoarteritis has different symptoms, it all depends on the form of the disease. Takayasu's disease can have a chronic course and an acute phase.
The acute phase of the disease is manifested by the following symptoms:
- General fatigue.
- When exercise causes pain in muscles and joints.
- Hemorrhagic rash appears.
- Erythema nodosum develops.
- The boundaries of the heart expand.
- Systolic and sometimes diastolic murmur appears.
- Abdominal pain rarely happens.
- If laboratory tests are done, they show moderate anemia, the presence of C-reactive protein.
Quite often these symptoms are misdiagnosed as "rheumatoid arthritis", "tuberculosis" or "sepsis". This unfortunately happens 95% of the time.
The course of the chronic stage of the disease
If effective measures are not taken from the first stages of the development of the disease to cure it, then the pathology soon becomes chronicstage. Symptoms already differ from those in the acute phase:
- Virtually no pulse on one arm, sometimes both.
- Patients often complain of pain in the limbs, which only increase with increasing load.
- Hands become weak, people have difficulty holding objects.
- Dizziness becomes frequent, which can result in loss of consciousness.
- When visiting an ophthalmologist, a change in the fundus is detected.
- Since coronary arteries are often involved in the process, ischemic attacks can be observed.
- When the abdominal aorta is affected, the kidneys begin to suffer.
- Neurological disorders appear in the form of impaired attention, memory, performance decreases.
- If the optic nerve is affected, vision suffers, double vision appears, blindness in one eye may occur.
- Involvement of the pulmonary artery leads to shortness of breath and chest pain.
- 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 vasoconstriction.
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. It is necessary to undergo a complete examination in order to establish an accurate diagnosis.
Diagnosis
If nonspecific aortoarteritis is suspected, early diagnosis is very important. This disease is recognized by doctors if the following symptoms are present:
- If there is a significant difference in blood pressure between arms.
- Pulse is very weak or not felt at all.
- Intermittent claudication appears.
- Auscultatory noises in the aorta.
- Examination reveals a narrowing of the artery.
- Aortic valve insufficiency.
- Persistent increase in pressure.
- ESR increased for unknown reason.
Final diagnosis will help the following studies:
- A biochemical blood test will show abnormalities in the composition of the blood that are characteristic of this pathology.
- Ultrasound examination of blood vessels allows you to assess their condition and blood flow rate.
- Angiography with the introduction of a contrast agent reveals the narrowing of the arteries.
- Chest X-ray shows the location of the aorta and pulmonary artery lesions.
- Echocardiography will evaluate the work of the heart.
- Electroencephalography can detect abnormalities in the blood vessels of the brain.
Thus, for any disease, including such as nonspecific aortoarteritis, the medical history begins with a complete examination, the purpose of which is to make the correct diagnosis.
Differential Diagnosis
It is very important when making a diagnosis to differentiate aortoarteritis from congenital anomalies of the vascular system and thromboembolism. The latter is characterized by an acute course with the possibility 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 renovascular arterial hypertension when making a diagnosis, then you must remember that it can also develop with atherosclerosis of the renal vessels. If nonspecific aortoarteritis develops mainly in young women, then atherosclerosis affects older men.
Only a complete examination and a competent specialist will help to accurately diagnose and begin effective treatment.
Clinical syndromes during pathology
Given that with this pathology, various parts of the vessels that supply blood to internal organs can be affected, several clinical syndromes can be distinguished:
- Peripheral blood flow insufficiency syndrome. At the same time, 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 - associated with the development of collateral circulation. Signs of myocarditis, ischemia can be diagnosed.
- If the aortic arch is affected, then cerebrovascular syndrome develops. Manifested by headaches, decreasedvision, cerebrovascular accident.
- Abdominal syndrome is manifested by pain in the abdomen, which has a paroxysmal character. This manifestation is not uncommon in lesions of the abdominal aorta.
- Hypertension syndrome - manifested as a result of damage to the renal arteries.
Therapy
If a diagnosis of non-specific aortoarteritis is made, treatment is called for:
- Significantly affect the focus of inflammation, if possible, reducing it to a minimum.
- Combat ischemic complications.
- Remove manifestations of arterial hypertension.
What to do if a person has nonspecific aortoarteritis? The diagnosis was made, the tests were passed, the task of the specialist is to build a treatment regimen. Therapy may be as follows:
- Medical.
- Surgical intervention.
Let's consider the indications and features of each option.
Treatment with drugs
Drugs for aortoarteritis are prescribed taking into account the severity of the patient's condition and the characteristics of the course of the inflammatory process. The most commonly prescribed drugs are:
- "Prednisolone" in the amount of 1-2 mg per kilogram of the patient's weight. Reception is carried out for 1-2 months.
- If the inflammation is weak, then taking aminoquinoline drugs is indicated, for example, Delagila 0.25 g each.
- Basic therapy is based on the use of "Methotrexate". The dosage is 7-10 mg per squaremeter of body surface. Reception - once a week.
- Auxiliary drugs are anticoagulants, cardiac drugs and blood pressure lowering drugs.
Drug therapy is long-term, if there is no improvement or there are pronounced disorders in the functioning of the limbs, the brain, it is recommended to resort to surgical intervention.
Surgical treatment
If conservative methods of treatment do not help, and the situation only gets worse, you will have to resort to the help of surgeons. Surgical intervention will help restore the blood supply to organs and tissues. But it must be borne in mind that the inflammatory process must be stopped before the operation. There are several methods of this kind of therapy:
- Endarterectomy. Performed in the presence of isolated segmental occlusions of arteries that branch directly from the aorta.
- Agnioplasty is performed if there are single changes in the vessels of the kidneys.
- Bypass is performed using synthetic vascular prostheses. Such an intervention is effective in multiple vascular lesions.
After surgery, the rehabilitation period is important, following the doctor's recommendations.
Advice for patients
We found out what non-specific aortoarteritis is, symptoms and treatment were also considered, but it is equally important for patients to observethe following recommendations:
- Each patient should be aware that the treatment of this disease requires time and compliance with all doctor's prescriptions.
- You need to stick to the scheme and dosage of medication 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, it is necessary to regularly undergo examinations and take tests.
- If the condition worsens, you must inform the specialist.
If you follow 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 if all the doctor's recommendations and effective drug treatment are followed, a remission stage can be achieved. This will allow patients to go about their usual 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.
Any disease requires a serious approach, the only way to achieve an improvement in the condition or even defeat the disease. Take care of your he alth and regularly undergo examinations - this way you can identify pathology in the early stages and choose an effective treatment.
