Acute Aortitis.

Definition.—Acute aortitis is an acute inflammation of the intima of the aorta, similar to that met with in the endocardium.

Etiology.—Nearly all cases of aortitis are preceded by some one of the infectious diseases,—typhoid fever, diphtheria, scarlet fever, tuberculosis, and others of the same class. Syphilis, rheumatism, and alcoholism are also important factors in producing' the disease. It may be an extension of endocarditis.

Pathology.—The morbid changes are so similar to those of acute endocarditis that a minute description of the pathological changes are unnecessary. As a result of increased cell proliferation, there is a thickening of the intima, some points of which are more pronounced than others, and these local spots may be covered by fibrinous deposits. These excrescences vary from the size of a shot to that of a cherry. Ulceration may follow, and portions of these fibrinous masses floating off may give rise to embolic infarcts.

Symptoms.—The local symptoms are usually characterized by pain, more or less severe, in the precordial region, or it takes the form of a tenderness and soreness on pressure in the sub-sternal region.

Sometimes the pain is intense, resembling angina pectoris.

There is usually some fever, though never marked unless embolism occurs; in such cases, rigors, night-sweats, and a high temperature curve, with prostration, will be the additional symptoms.

Palpitation is not uncommon, and a cardiac murmur may be heard over the region of the aorta.

Diagnosis.—A positive diagnosis' is almost impossible. The thoracic pain, more diffuse than in endocarditis, and the high seat of the murmur, would suggest aortitis.

Prognosis.—The prognosis is always unfavorable, as a fatal embolism or rupture of the aorta may occur without warning at any time.

Treatment.—The treatment will be along the same lines recommended for acute endocarditis, and will consist of rest, an easily digested diet, and the indicated remedy.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.