CARDIOVASCULAR MANIFESTATIONS OF HORTONS- DISEASE - AN UNDERESTIMATEDDISEASE IN CARDIOLOGY

Horton's disease is a giant cell arteritis well known for its presenta tion as temporal arteritis. It is, in fact, a systemic disease which a ffects over 1% of the general populations after 50 years of age. With the exception of the risk of blindness by occlusion of the ophthalmic artery, the cardiovascular manifestations of Horton's disease are not well known and probably underestimated by clinicians. The main complic ations are involvement of the large arteries, especially the thoracic aorta and subclavian and axillary arteries, the femoro-popliteal axis and supra-aortic arterial vessels. During the initial phase of the dis ease, extension of arteritis to the carotid and vertebral arteries is of particular concern because of the risk of cerebral infarction. The coronary arteries, myocardium, pericardium of pulmonary arteries may a lso be affected by the inflammatory process. In the long-term, Horton' s disease may be complicated by aneurysms, dissection of parietal rupt ure of the thoracic aorta. Treatment is based on steroid therapy, some times associated with antiplatelet agents or anticoagulants during the initial phase of treatment. Long-term follow-up is justified because of the risk of late aortic complications.