Aortitis is defined as an inflammatory process that involves one or more layers 
of the aortic wall (internal elastic lamina, tunica media, and adventitia) and 
can be caused by multiple mechanisms. Clinical features are usually nonspecific 
and a high index of suspicion is required for making the diagnosis. Although 
noninvasive imaging studies are being increasingly used in evaluating patients 
for diagnosis, angiography remains the gold standard for confirming aortic 
involvement. When tissue is available, pathologic examination can aid in 
clarifying the diagnosis. Aortitis, irrespective of the underlying cause, 
frequently displays similar clinical, pathologic, and arteriographic features 
and therefore understandably presents a therapeutic and diagnostic dilemma. 
Whatever the cause, early identification and aggressive treatment is required in 
order to avert the potentially life-threatening sequelae. The treatment of 
aortitis is determined by the underlying cause. If diagnosed early, infectious 
aortitis responds to appropriate antimicrobial therapy, whereas noninfectious, 
immune-mediated aortitis requires immunosuppressive therapy. However, in many 
instances, primarily because of the delay in diagnosis, surgical intervention is 
necessary to treat the associated anatomic and physiologic sequelae. Less 
definitive and more controversial is the role of inflammation in both primary 
and secondary accelerated atherosclerosis of the aorta and its modality of 
treatment.