Giant cell arteritis involving the temporal arteries is a frequently considered diagnosis in the elderly population. These patients classically present to the physician with complaints of fever, headache, myalgias, and visual changes with laboratory abnormalities, including increased erythrocyte sedimentation rate and anemia. A much less appreciated characteristic of giant cell arteritis is the predilection for large artery involvement. Larger artery involvement, including the aorta, has been documented in a series of patients with giant cell arteritis. The clinical association between giant cell arteritis and aortic regurgitation has been alluded to in previous case reports. To our knowledge, there has been only one previous case of documented giant cell arteritis of the temporal arteries by histologic biopsy specimen years before the development of aortic regurgitation. This case did not document histologic involvement of the aorta by giant cell arteritis.
Presented are two well-documented cases of severe aortic regurgitation secondary to giant cell arteritis occurring in elderly patients with a remote history of histologically proven giant cell arteritis of the temporal arteries. This association is important because it gives the clinician a cause for severe aortic regurgitation in the patient with a history of giant cell arteritis of the temporal artery. Patients with giant cell arteritis require close observation for subsequent development of severe aortic regurgitation.