Aortic Aneurysms Caused By GCA

I was diagnosed in June 2024 when I went to the hospital emergency room for vision problems. While I was at the hospital they did a lot of tests on me. The tests included an MRI of my head, EKG, EEG, and ultrasound of my heart and aorta. So those tests confirmed that everything was ok at that time, except for the arteries in and outside my head affected by the GCA. Several months later I asked my rheumatologist if they would monitor my aorta, and she said a cardiologist would do that if I ever had any symptoms suggesting problems.

I get it. The head symptoms not easy to miss. I am going to get Cardiologist to talk about aorta. I have had it checked by ultrasound before the GCA occurred. I want it done again now.

Hello @jeff97 and welcome to the GCA/PMR blog.

For some background informaiont about aortic aneurysms. The general population develop aortic aneurysms at the rate of 1.8%. Studies show that GCA/PMR patients develop aortic aneurysms at the rate of 3.6% over a 5 year period. That means that over a 5 year period 2 additional perple will develop an aortic aneurysm over the general population. Just some background info for your thought. It not really a heavy hitter.

It sounds like you are also blessed by catching the GCA before major vision problems began. Good Luck in the future with GCA.

A recent CT scan after an emergency admission to hospital was able to pick up potential inflammation in and around the aorta. That lead to a PET scan two weeks later that cleared me of any GCA / LVV issues with the aorta. So it seems that both a CT or PET scan will pick up issues from GCA in the aorta. I'm in Australia and it was very much the responsibility of the rheumatologist to request the PET scan. As I had been under general practitioner care only for the last 2 years, for PMR, I had to get a referral specifically to a rheumatologist to get the PET done.

Thanks for the good wishes and for the information about aortic aneurysms.

thank you for posting about this situation. I too had the same concerns that I might have some GCA occurring in my coronary arteries, silently without the unmissable headache. I remember asking what kind of checking we would do over longer term (months years) and got blank stares. In defense of the medical people, I think they were more concerned about getting my GCA into remission status which is where I currently am. As far as I am aware an aortic aneurysm might occur without symptoms so the
wait-to-see if there are symptoms isn’t a logical approach. Thanks to all for contributing to this thread.

That is what concerns me. It seems like the common posture of the doctors is to WAIT until something happens rather than periodically take a preventative testing protocol.
I do not like the blank stares

Current research indicates that the level of risk of GCA r aneurysm is related to large vessel involvement as opposed to limited to temporal artery involvement. For those who want to slog through the most recent scientific update on GCA (August 2025), the link is below. This website is open to physician subscription only. There are versions for laypersons, but they don’t have as much detailed information.
https://www.uptodate.com/contents/clinical-manifestations-of-giant-cell-arteritis

I understand your concern. The "wait and see" posture is part of the problem. The other part is what might be done differently to prevent something from occurring.

There is no such thing as "preventative testing." The testing doesn't prevent anything. An aneurysm is often found in the general population and nothing is done. Treating an aneurysm might be more risky than conservative management -- otherwise known as little or no treatment. When there is something that can be done ... the treatment might introduce additional risks.

When the standard of care for GCA is prednisone what else can be done?
Patients are already convinced that many of the preventative measures for Prednisone side effects aren't necessary. For autoimmune conditions, remission comes first and "potential damage" from the condition is more in the realm of "watchful waiting."

I am somewhat happy with the conservative management approach. I have refused recommended tests and recommended corrective action. When they find something ... doctors often aren't sure what to do so I'd rather not know about the problem. I have enough medical problems already. I have a tortuous aorta that showed up on several scans that I choose to ignore. No doctor has ever mentioned my aorta to me because my spine is much worse. My spine gets flagged as "immediate action required."