The heart in temporal arteritis / giant cell arteritis
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Overview
Cardiac involvement with Giant-cell arteritis or temporal arteritis is rare. Patients with either condition may experience chest pain if they have aortic root involvement or myocardial infarction.
Granulomatous giant-cell arteritis could be present with [temporal arteritis] in 10-15% of patients, or it could manifest on its own. The use of tissue analysis to find granulomatous giant cell coronary arteritis is rare, as are proven cases leading to fatal [myocardial infarction].[1]
Giant cells can be found along the degenerative internal elastic membrane of the arterial wall. The intima thickens to the point it becomes a fibrous cord. Harrison may have also noticed luminal thrombosis in 16 cases of [temporal arteritis], though only one involved the epicardial coronary arteries. Giant-cell arteritis of intramural coronary arteries is also possible. [1]
Vascular inflammation in giant cell arteritis can be widespread. Branches of the proximal aorta, especially those supplying the neck, extracranial structures of the head, and upper extremities, tend to be affected most prominently.
Extracranial vascular involvement is clinically detectable in 10-15% of patients with giant cell arteritis. It often presents dramatically as an unsuspected cause ofaortic dissection or ruptured aortic aneurysm in the elderly [2]
CT scans and MRI with T2-weighted images are enough for diagnosis.
References
- ↑ 1.0 1.1 Poole-Wilson, Philip A.; Fuster, Valentin; O'Rourke, Robert A.; Walsh, Richard (2008). Hurst's the heart. McGraw-Hill Medical. ISBN 00714788689780071478861 Check
|isbn=value: length (help). - ↑ Liang B A, Qureshi J, Wilke W S. Giant Cell Arteritis: Diagnosis and Management. Hospital Physician February 2003, 48-58