UNASSIGNED: A 53-year-old female with a history of smoking presented with progressively worsening chest and epigastric pain over several weeks. She had seen multiple physicians previously for the same symptoms with unremarkable work-ups. Physical examination was notable for severe tenderness upon palpation of her lower abdomen. The electrocardiogram and troponins were unremarkable. Computed tomography of the abdomen revealed aneurysmal dilatation of the abdominal aorta, soft tissue thickening, and surrounding inflammatory stranding, consistent with aortitis. Infectious and autoimmune work-ups were unremarkable. Intravenous steroids were initiated, and her symptoms improved significantly. Her aortitis was attributed to inflammation secondary to chronic smoking.
UNASSIGNED: Aortitis is a rare condition with varied clinical presentations. Etiologies of aortitis include infection and non-infectious inflammation. Diagnosis of aortitis requires a thorough clinical assessment and prompt imaging of the aorta, with computed tomography being the preferred imaging modality.
UNASSIGNED: Evaluation for cardiovascular chest pain must extend beyond an electrocardiogram and troponin level. Imaging should be considered in patients with atypical symptoms. Aortitis is a rare but important diagnosis requiring immediate treatment.
■一名53岁女性,有吸烟史,在几周内表现为胸部和上腹部疼痛逐渐恶化。她以前曾因相同的症状而看过多位医生,但没有明显的治疗。体格检查明显触诊下腹部时出现严重压痛。心电图和肌钙蛋白无明显变化。腹部计算机断层扫描显示腹主动脉动脉瘤扩张,软组织增厚,和周围的炎症搁浅,与主动脉炎一致。传染性和自身免疫性检查并不明显。开始静脉注射类固醇,她的症状明显改善。她的主动脉炎归因于慢性吸烟继发的炎症。
■主动脉炎是一种罕见的疾病,临床表现多样。主动脉炎的病因包括感染和非感染性炎症。主动脉炎的诊断需要彻底的临床评估和主动脉的及时成像,计算机断层扫描是首选的成像模式。
■心血管性胸痛的评估必须超出心电图和肌钙蛋白水平。症状不典型的患者应考虑影像学检查。主动脉炎是一种罕见但重要的诊断,需要立即治疗。