“Arteritic” describes a medical condition characterized by inflammation of the arteries, blood vessels that carry oxygen-rich blood away from the heart. When arteries become inflamed, their walls can thicken, swell, and narrow. This narrowing can reduce or even block blood flow, potentially leading to various health complications in the tissues and organs supplied by the affected vessels.
Understanding Arteritis
Arteritis represents a specific form of vasculitis, a broader category of diseases involving inflammation of blood vessels. The inflammation specifically targets the arterial walls. This inflammatory process can damage the vessel structure, causing thickening, weakening, or scarring of the arterial wall. Consequently, the internal diameter of the artery may decrease, impeding blood flow. Reduced blood flow can deprive downstream tissues of necessary oxygen and nutrients, and the damaged vessel wall can also become a site for blood clot formation, further obstructing circulation. This distinguishes arteritis from other vascular problems like atherosclerosis, which primarily involves plaque buildup without initial inflammation of the vessel wall.
Primary Arteritic Conditions
The term “arteritic” often refers clinically to Giant Cell Arteritis (GCA), also known as Temporal Arteritis, as it is the most common form of vasculitis affecting large and medium-sized arteries in adults. GCA typically involves arteries of the head and neck, including the temporal arteries, the ophthalmic artery, and sometimes the aorta and its major branches. The exact cause remains unknown, but it is thought to involve an autoimmune response where the body’s immune system mistakenly attacks its own arterial tissues.
Another significant form of arteritis is Takayasu Arteritis, a chronic inflammatory disease that primarily affects the aorta and its main branches, such as the subclavian, carotid, and renal arteries. This condition tends to occur in younger individuals, often women under 40, and can lead to narrowing, blockage, or weakening of these large vessels. While both GCA and Takayasu Arteritis involve arterial inflammation, they differ in the typical age of onset and the specific arteries most commonly affected.
Recognizing Symptoms
Symptoms of arteritis can vary depending on which arteries are affected, but some general patterns emerge, especially in Giant Cell Arteritis (GCA). A new-onset headache, often severe and localized to the temples, is a common symptom in GCA, sometimes accompanied by scalp tenderness, which can make brushing hair painful. Jaw claudication, characterized by pain in the jaw muscles when chewing, is another distinct feature due to reduced blood flow to these muscles. Vision changes include blurred vision, double vision, temporary vision loss (amaurosis fugax), or sudden, permanent vision loss in one or both eyes. General symptoms like unexplained fever, fatigue, weight loss, and muscle aches (polymyalgia rheumatica) can also occur, and the sudden onset of vision-related symptoms warrants immediate medical attention to prevent irreversible damage.
Diagnosis and Treatment
Diagnosing arteritis involves a combination of methods, beginning with a thorough physical examination to assess for signs like scalp tenderness or diminished pulses. Blood tests are frequently performed to detect inflammation, with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) being common indicators of active inflammation. For suspected Giant Cell Arteritis, a temporal artery biopsy is often the definitive diagnostic test, involving microscopic examination of a small artery segment. Imaging techniques such as ultrasound, magnetic resonance imaging (MRI), or positron emission tomography (PET) scans can also visualize inflamed arteries, particularly when large vessels like the aorta are suspected.
Treatment for arteritis primarily focuses on reducing inflammation and preventing further arterial damage and complications. High doses of corticosteroids, such as prednisone, are the primary therapy due to their anti-inflammatory effects. Prompt initiation of corticosteroid treatment, especially for Giant Cell Arteritis, is crucial to prevent irreversible complications like permanent vision loss. The dosage is high initially and then gradually tapered over several months or even years as the inflammation subsides. In some cases, other immunosuppressive medications or biologic agents may be used in conjunction with or as an alternative to corticosteroids, particularly if the patient cannot tolerate corticosteroids or if the disease is resistant to initial treatment.