There is a disease that may make people think that they are born without a pulse.
Because it occurs in China, Japan, India and other Asian oriental countries, young women under the age of 30 are also named "Oriental Beauty Disease".
"Oriental beauty disease" is actually an autoimmune vasculitis, medically called aorticitis, mainly the aorta and its first-level branch of the arterial wall of chronic inflammation, so that the blood vessels are evenly thickened, and eventually lead to narrowing, occlusion and so on.
A small number of young patients may develop aneurysms and tumor-like dilations. A small number of people may also have local veins involved by arteries, and some changes such as venous reactive inflammation, hyperplasia, and lymphadenopathy may occur.
01 The cause of aorticitis is unknown and the onset is insidious
At present, the cause of aorticitis is not very clear. But according to current research, it is likely to be closely related to some susceptibility genes, such as human leukocyte antigen HLA-B52, or estrogen.
It may also be associated with pathogenic microbial infection. Infection triggers the body's immune mechanism, and while eliminating the pathogenic microorganism, it may accidentally injure the walls of blood vessels with similar components to the pathogenic microorganism.
The onset of aortic arteritis is often relatively insidious, and the affected blood vessels may gradually and evenly thicken under the influence of chronic wall inflammation for several years or even decades, showing "macaroni"-like changes in imaging examination, and slowly appearing luminal stenosis and occlusion.
Mild stenosis is often difficult to detect without examination, and is often detected after causing severe ischemic lesions of important organs such as cerebral infarction.
02 But there are still traces of aortitis
Symptoms of aortitis vary depending on the site of vascular involvement, and 100 patients may have 100 clinical manifestations.
The aorta is an important artery that supplies blood throughout the body, and after emanation from the left atrium, it can be divided into three stages: ascending aorta, aortic arch, and descending aorta.
The ascending aorta, the left and right coronary arteries at the root of the aorta, supply blood to the heart.
If the root of the aorta is blocked, it may cause poor blood supply to the heart, coronary heart disease, myocardial infarction, etc.
The aortic arch is divided into the left subclavian artery, the left common carotid artery, and the main artery of the cephalic arm, and the trunk artery of the cephalic arm is divided into the right subclavian artery and the right common carotid artery, which supplies blood to the neck, craniofacial face, and arms.
If stenosis and occlusion occur, symptoms such as weakened or even disappeared pulse, inconsistent blood pressure in both arms, cerebral ischemia, cerebral infarction, and blindness may occur.
Descending aorta, divided into thoracic aorta, abdominal aorta, abdominal aorta can also be divided into renal artery, common hepatic artery, superior mesenteric artery, inferior mesenteric artery, left and right iliac arteries, etc., to supply blood to the chest diaphragm, liver, kidney, stomach and so on.
If stenosis or occlusion occurs, gastrointestinal symptoms such as nausea and vomiting may occasionally occur, or difficult to control hypertension may occur.
Some patients with more severe onset may also have systemic symptoms such as unexplained fever and fatigue.
03 The diagnosis can be made by meeting three of the six criteria
/ Imaging: Intuitive Diagnosis /
Diagnosis of aortitis is relatively dependent on imaging tests, including magnetic resonance imaging, CT, and ultrasonography.
Magnetic resonance examination, the observation of more information, can more clearly see the blood vessel wall inflammation, and the severity of inflammation, but also can see the thickness of the blood vessel wall, blood vessel narrowing, occlusion.
For patients who present for the first time, MRI is recommended, but only a few hospitals are currently in a position to do MRI for arteries.
CT examination can observe the presence or absence of "macaroni signs", that is, whether the blood vessel wall is thickened and the lumen is narrowed.
However, CT cannot tell whether the thickening of the tube wall is inflammatory or due to other causes such as fibrosis.
Ultrasonography is suitable for observing some superficial arteries, such as carotid arteries and subclavian arteries, while deeper blood vessels such as the thoracic aorta cannot be used.
The advantage of ultrasonography is that not only the thickness of the blood vessel wall can be seen, but also the blood flow.
/ Laboratory tests: only for reference /
Patients may present with increased erythrocyte sedimentation rate, elevated C-reactive protein, and elevated immunoglobulin, but everything may be normal.
You can also do some liver function, kidney function, fundus examination, etc., to see if the function of the organs at the blood vessel supply site is affected.
Examination of antibodies can help rule out some autoimmune diseases, but because the marker antibodies of aortitis, that is, the specificity of anti-vascular endothelial cell antibodies and anti-aortic antibodies, they can also be positive in some other diseases such as vasculitis and Behcet's disease, so they are often used as reference indicators.
Finally, remind again, vascular occlusion is no small matter, if you find abnormalities, you must go to the hospital as soon as possible for treatment!
Reference: Medical Microvision official website - Pan Lili Chief Physician "Aorticitis"