A Case of Severe Advanced Takayasu Arteritis with Acute Myocardial Infarction as First Manifestation (original) (raw)

Takayasu Arteritis with Coronary Aneurysms Causing Acute Myocardial Infarction in a Young Man

Texas Heart Institute …, 2011

Takayasu arteritis is an inflammatory condition that involves the large cardiac vessels, predominantly the aorta and its main branches. It typically affects young women (age, ≤40 yr), most often Asians and Latin Americans. Herein, we describe a rare manifestation of Takayasu arteritis in a 19-year-old black Tunisian man who presented with acute inferior myocardial infarction and complete atrioventricular block after occlusion from a giant aneurysm in the right coronary artery. The coronary artery disease was associated with aneurysmal dilations in the carotid, vertebral, and right renal arteries. Medical therapy improved Thrombolysis in Myocardial Infarction flow in the area of the giant aneurysm from grade 1 to grade 3. Upon the diagnosis of Takayasu arteritis, intravenous methylprednisolone and oral prednisone therapy was started. After 10 days of hospitalization, the patient was discharged on a medical regimen. Renovascular hypertension due to renal artery stenosis was suspected, so he underwent successful percutaneous transluminal angioplasty of the inferior segmental artery of the right renal artery. During 12 months of close postprocedural monitoring, he experienced lower blood pressure, no chest pain, and no cardiovascular complications.This association of conditions has not been previously reported. Besides presenting this very rare combination of findings, we discuss the differential diagnosis of Takayasu arteritis in our patient.

Refractory Takayasu’s Arteritis with Severe Coronary Involvement—Case Report and Literature Review

Journal of Clinical Medicine

This report presents the case of a female patient diagnosed with Takayasu arteritis from childhood, with severe, refractory coronary involvement, leading to two acute coronary syndromes and multiple anginous episodes. Consequently, the patient suffered aorto-bicarotid bypass two times, multiple interventional procedures with stent implantation, balloon angioplasty, and up to ten repeated in-stent restenosis that required reinterventions, despite being on maximal immunosuppressive treatment. In recent years, various studies have been reported that aim to best characterize this particular type of vascular damage and to indicate optimal therapeutic options for treatment. The latter should be based on the activity of the underlying disease; however, no reliable markers are available in TA. The management of TA patients with coronary involvement continues to be a challenge and requires both drug and interventional techniques to avoid life-threatening events.

A typical presentation of Takayasu's arteritis – Takayasu's arteritis with dilated cardiomyopathy

International Journal of Clinical Biochemistry and Research, 2015

A young female was diagnosed with Takayasu's arteritis based on clinical features, investigations and resolution of symptoms with steroids. This case illustrated that Takaysu's arteritis can have varied presentation and early diagnosis along with treatment has Improved the symptoms and prevent the classical manifestation of Takayasu's arterit is.

Cardiomyopathy as one of the less frequent manifestations of Takayasu's arteritis

Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové, 2011

The authors present the case of a young woman with newly diagnosed Takayasu's arteritis. This woman, with arterial hypertension, was investigated for the unspecific symptoms at the beginning. Afterwards, the transthoracic echocardiography showed dysfunction of the left ventricle and the abdominal sonography showed a stenosis of the right renal artery. PET/CT scan showed chronic modification after inflammatory processes on the wall of the thoracic and abdominal aorta. This case report should be instructive to other clinicians and refers to the necessity to remember this rare disease in our country too.

Ischemic Cardiomyopathy in a Case of Takayasu\'s Arteritis

Bengal Physician Journal, 2021

Takayasu's arteritis (TA) is a rare form of granulomatous vasculitis of unknown etiology. It is also known as "pulseless disease" or "aortic arch syndrome" and commonly occurs in young-or middle-aged females. We describe a 28-year-old female who presented with chest pain and dyspnea in the

A rare case of Takayasu Arteritis in young woman with heart failure -A case report

Takayasu arteritis (TA) is a rare, systemic, granulomatous primary vasculitis of medium and large arteries. The name comes from Dr. Mikito Takayasu, who reported the problem in 1905 for the first time. It is also called as Pulseless Disease or Aortic Arch Syndrome and usually seen before 40 years with female and male ratio being 10:1. Takayasu arteritis is a major cause of high blood pressure levels in teenagers and young adults. Around 75 percent of the people having Takayasu get diagnosed usually at an average age of 29 years though they begin to show the symptoms at their teenage years because the early symptoms of Takayasu are nonspecific and common. Heart failure as the first presentation of the TA is rare but has been reported. Angiographic studies help in the diagnosis of Takayasu and patients usually respond to steroid therapy. We report a 16 years old female presented with history of upper limb claudication, dyspnea, orthopnea, non palpable pulse in bilateral upper limbs with non recordable BP, lower limb with high blood pressure recordings and bilateral carotid Bruit present. Imaging studies revealed circumferential wall thickening of arch of aorta, bilateral carotids, left sub clavian, left axillary. 2D echo revealed global hypokinesia with severe left ventricular dysfunction. Takayasu arteritis with heart failure diagnosis was made and administration of steroids, diuretics and ACE inhibitor improved the condition.

A Rare Case of Non-Ischemic Dilated CardiomyopathyRevealing a Takayasu Arteritis

2020

Background: Takayasu arteritis is a rare, systemic, inflammatory large vessel arteritis of unknown aetiology. It predominantly involves the aorta and its major branch arteries. It commonly occurs in women younger than 50 years of age. It can affect the cardiovascular system and renovascular hypertension and aortic regurgitation are the most prevalent manifestations. Dilated cardiomyopathy is rare and commonly due to renal artery stenosis or coronary artery involvement, otherwise, it is extremely rare. Case Presentation: We are reporting a case of a 37-year-old woman presenting to the Emergency Department with acute stage IV NYHA dyspnea and orthopnea. Symptoms and signs were suggestive of acute decompensated heart failure which was managed medically using IV furosemide and nitrates. Transthoracic echocardiogram revealed a dilated cardiomyopathy, LVEF at 28%. Coronary artery angiography showed a distal chronic complete obstruction of left anterior descending artery with a subocclusio...

Management of cardiac manifestations in Takayasu arteritis

Vessel Plus, 2020

Takayasu arteritis (TA) is a chronic vasculitis involving large vessels of unknown aetiology, a disease that is more common among the Asian population and predominant in young women. Cardiac manifestations include hypertension and involvement of the cardiac valves, myocardium and coronary arteries. Surgery on these patients is always a challenge given the tissue quality and the disease activity. They are prone to long-term complications such as restenosis and graft occlusion, hence requiring lifelong surveillance. The prevalence of coronary artery disease (CAD) in TA ranges from 9 to 11%. Coronary artery bypass grafting is preferred to percutaneous coronary intervention, as the latter has a high rate of restenosis and major adverse cardiovascular events. As left subclavian artery is commonly involved, saphenous vein graft is advised as a conduit rather than internal mammary artery. Other surgical procedures described for CAD are surgical angioplasty of the left main coronary artery and transaortic coronary ostial endarterectomy. Aortic regurgitation in TA has an incidence of approximately 20%. These patients tend to have prosthetic valve detachment, paravalvular leak or pseudoaneurysm at the anastomotic site. Further repair of these valves have a high rate of failure. Considering these facts, it is advisable to do an aortic root replacement for TA patients than to consider an aortic valve replacement or David's procedure.