Aortoarteriitis nonspecific: symptoms and methods of treatment

Currently, there is 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 these ailments - this is aortoarteriitis nonspecific, from which the female sex most often suffers, and the young age. The disease is most often diagnosed in Asian countries. Let's understand the reasons for its occurrence, symptoms, and at the same time discuss whether it is possible to cope with this pathology.

The essence of the disease

Nonspecific aortoarteriitis is a rheumatic disease in which the internal surface of the arteries and their branches are affected. If the inflammatory process progresses, the walls of the vessels thicken, the smooth muscle layer begins to break down and is replaced by a connective tissue, and granulomas consisting of huge cells appear in the vessels.

As a result of such processes, a blood vessel expands and protrudes, an aneurysm develops. If the process is not stopped, then all ends with the withering away of elastic fibers of smooth muscle tissue. Begin to suffer organs and tissues due to impaired blood flow. In the international system of classification of diseases, each disease has its own code, not an exception, nonspecific aortoarteriitis. ICD gave him the code M31.4 (aortic arch syndrome).

Causes of the disease

To date, the reasons that are provoking the development of this pathology, and not established. Most researchers who deal with this issue are of the opinion that not the least role in this is played by infections that lead to immunodeficiency states. This view is due to the fact that nonspecific aortoarteriitis is often combined with diseases based on immune disorders.

At present, there is a group of scientists who are inclined in favor of an autoimmune theory of the development of the disease. This is confirmed by the detection of anti-aortic antibodies in patients with plasma.

We can say that the autoimmune mechanism of the disease can be confirmed, but whether it is primary, or arises in response to the inflammatory process - it is still difficult to say.

Classification of the disease

Aortoarteriitis nonspecific happens of different types depending on the area of the lesion:

1. The first type - in this case only the arch of the aorta and small branches that leave it are affected.
2. In the second type, the arteries in the thoracic and abdominal parts are affected.
3. The third type - the aortic arch is affected along with the thoracic and abdominal parts.
4. The fourth is characterized by a lesion of the pulmonary artery.

According to whatever scheme develops nonspecific aortoarteritis (Takayasu's disease), disability threatens patients very often. Especially if the diagnosis is too late.

Symptomatic of the disease

Nonspecific aortoarteriitis symptoms is different, it all depends on the form of the disease. Takayasu's disease can have chronic course and acute phase.

The acute phase of the disease is manifested by the following symptoms:

• General fatigue.
• At physical exertion there are pains in muscles and joints.
• Appears hemorrhagic rash.
• Nodular erythema develops.
• Cardiac boundaries expand.
• There is systolic, and sometimes diastolic noise.
• Seldom are pains in the abdomen.
• If you perform laboratory tests, they show a mild anemia, the presence of C-reactive protein.

Quite often when such symptoms are manifested, they make an erroneous diagnosis - "rheumatoid arthritis", "tuberculosis" or "sepsis". This, unfortunately, happens in 95% of cases.

The course of the chronic stage of the disease

If the first stages of the development of the disease do not take effective measures to cure it, then the pathology soon turns into a chronic stage. The symptomatology is already different from that in the acute phase:

• Practically there is no pulse on one hand, and sometimes on both.
• Patients often complain of pain in the limbs, which only increase when the load increases.
• Hands become weak, people are hard to keep things.
• Dizziness becomes frequent, which can result in loss of consciousness.
• When you visit the oculist, a change in the fundus is detected.
• Since coronary arteries are often involved in the process , it is possible to observe ischemic attacks.
• When the abdominal aorta is affected, the kidneys begin to suffer.
• Neurological disorders are manifested in the form of violation of attention, memory, working capacity decreases.
• If the optic nerve is affected, vision is impaired, double vision appears, eye blindness can occur.
• Involvement of the pulmonary artery leads to the development of dyspnea, there are pains in the chest.
• Suffer the joints of the hands.
• With nonspecific aortoarteritis, the spread of the process begins with the main arteries, which, as a rule, leads to an increase in arterial pressure due to narrowing of the vessels.

Usually the acute phase of the disease turns into chronic for 6-8 years. Patients should be alerted if they are constantly tormented by weakness, headache, pain along the course of large arteries, impaired coordination and memory. It is necessary to undergo a complete examination in order to establish an accurate diagnosis.

Establishing diagnosis

If there is a suspicion of nonspecific aortoarteritis, 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 on different arms.
• The pulse is strongly weakened or not palpable at all.
• Intermittent claudication occurs.
• When listening, there are noises in the aorta.
• The examination reveals narrowing of the artery.
• Insufficiency of the aortic valve.
• Persistent increase in pressure.
• ESR increased for no apparent reason.

Final diagnosis will help the following studies:

1. Biochemical blood test will show the deviations in the blood composition, which are characteristic for this pathology.
2. Ultrasound examination of blood vessels allows to assess their condition and blood flow velocity.
3. Angiography with the introduction of contrast agent reveals places of narrowing of the arteries.
4. X-ray examination of the chest determines the location of the lesions of the aorta and pulmonary artery.
5. Echocardiography will evaluate the work of the heart.
6. Through electroencephalography, it is possible to detect abnormalities in the blood vessels of the brain.

Thus, in any disease, including in a case such as nonspecific aortoarteritis, the case history begins with a complete examination, the purpose of which is to establish the correct diagnosis.

Differential diagnostics

It is very important to differentiate aortoarteriitis from congenital anomalies of the vascular system and thromboembolism when diagnosing. The latter is characterized by acute leakage with the possibility of a thrombus formation in the cavity of the heart muscle.

An important distinctive feature is that aortoarteriitis non-specific affects groups of vessels, while in congenital anomalies certain arteries suffer.

If you rely on the diagnosis of renal arterial hypertension, you need to remember that it can also develop with atherosclerosis of kidney vessels. If aortoarteritis non-specific develops mainly in young women, then atherosclerosis affects older men.

Only a full examination and a competent specialist will help to accurately diagnose and start effective treatment.

Clinical syndromes during pathology

Given that this pathology can affect various areas of blood vessels that supply blood to the internal organs, you can identify several clinical syndromes:

1. Syndrome of insufficiency of peripheral blood flow. At the same time there are pains in the hands with a feeling of numbness of the fingers. If vertebral arteries are affected , then the pain is present in the back.
2. Cardiovascular syndrome - is associated with the development of collateral circulation. Can be diagnosed signs of myocarditis, ischemia.
3. If the arch of the aorta is affected, then cerebrovascular syndrome develops. Is manifested by headaches, decreased vision, impaired cerebral circulation.
4. Abdominal syndrome manifests itself in abdominal pain, which has a paroxysmal character. This manifestation is not uncommon in lesions of the abdominal aorta.
5. Syndrome of arterial hypertension - manifested as a consequence of the defeat of the renal arteries.

Therapy

If the diagnosis is "nonspecific aortoarteritis," the treatment is designed:

1. It is essential to influence the inflammation focus, if possible, reducing it to a minimum.
2. Fight with ischemic complications.
3. Remove the manifestations of hypertension.

What to do if a person has nonspecific aortoarteritis? Diagnosis is carried out, analyzes are handed over, the task of a specialist is to build a treatment regimen. Therapy can be as follows:

• Medicamentous.
• Surgical intervention.

Consider the indications and features of each option.

Treatment with drugs

Medication at aortoarteriitis is prescribed taking into account the severity of the patient's condition and the peculiarities of the course of the inflammatory process. Most often the following drugs are prescribed:

• "Prednisolone" in the amount of 1-2 mg per kilogram of the patient's weight. Admission is carried out for 1-2 months.
• If the inflammation is of a weak nature, then the use of aminoquinoline preparations is indicated, for example, "Delagila" in 0.25 g.
• Basis therapy is based on the reception of Methotrexate. Dosage is 7-10 mg per square meter of the body surface. Reception - once a week.
• Auxiliary drugs are anticoagulants, cardiac drugs and drugs that lower blood pressure.

Drug therapy has a long-term character, if there are no improvements, or there are obvious violations of the limbs, the brain, it is recommended to resort to surgical intervention.

Surgery

If conservative methods of treatment do not help, and the situation is only aggravated, it will be necessary to resort to the help of surgeons. Surgical intervention will help restore 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 the arteries that extend directly from the aorta.
• Agnioplasty is performed if there are single changes in the vessels of the kidneys.
• Bypass grafting is performed using synthetic vascular prostheses. Such an intervention is effective in multiple vascular lesions.

After surgery, the rehabilitation period is important, adherence to the doctor's recommendations.

Recommendations for patients

We found out what aortoarteriitis is unspecific, the symptoms and treatment were also considered, but for patients it is equally important to observe the following recommendations:

1. Each patient should be aware that the therapy of this disease requires time and compliance with all prescriptions of the doctor.
2. It is necessary to adhere to the scheme and dosage of taking medications, which the doctor advised.
3. Since a large number of drugs are taken during therapy, there is a risk of developing various undesirable effects. To minimize them, you must regularly undergo a test and take tests.
4. If the condition worsens, tell the specialist.

If you adhere to these recommendations, then therapy of the disease will be more successful.

Forecast for patients

Unfortunately, it is impossible to completely get rid of nonspecific aortoarteritis, but with all the recommendations of the doctor and effective medication, you can achieve a remission stage. This will allow patients to engage in routine activities and not to experience painful sensations.

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. For the result of therapy to be positive, it is necessary to detect the disease in the early stages.

There are no special preventive measures.

Any disease requires a serious approach, the only way to achieve an improvement in the state or even defeat the disease. Take care of your health and regularly undergo examinations - so you can identify pathology in the early stages and choose an effective treatment.