The heart in temporal arteritis / giant cell arteritis

Assistant Editor-in-Chief: Brian Blank

Overview
Extracranial vascular involvement is clinically detectable in 10-15% of patients with giant cell arteritis(GCA) or temporal arteritis. It often presents dramatically as an unsuspected cause ofaortic dissection or ruptured aortic aneurysm in the elderly Cardiac involvement with Giant-cell arteritis (GCA) or temporal arteritis is rare. Patients with GCA may experience chest pain if they have either aortic root involvement or myocardial infarction.

Pathology
The use of tissue analysis to find granulomatous giant cell coronary arteritis is rare, as are proven cases leading to fatal [myocardial infarction]. Giant cells can be found along the degenerative internal elastic membrane of the arterial wall. The intima thickens to the point it becomes a fibrous cord. Harrison may have also noticed luminal thrombosis in 16 cases of temporal arteritis, though only one involved the epicardial coronary arteries. Giant-cell arteritis of intramural coronary arteries is also possible.

Imaging studies
CT scans and MRI with T2-weighted images are enough for diagnosis.