An unusual case of acute heart failure
Abstract
Takayasu’s arteritis is a large vessel vasculitis of unknown etiology affecting predominantly young women. This case report describes an atypical presentation of this disease in a 49-year-old Caucasian woman who presented in acute congestive heart failure. Workup showed occlusion and stenosis of multiple branches of the aorta, including the left subclavian, right renal, celiac artery, and superior mesenteric artery. She had moderate aortic regurgitation, an aneurysm of the ascending aorta, and a severely reduced ejection fraction of <20%. Clinical and radiographic improvement occurred following prompt immunosuppressive treatment with corticosteroids.
Keywords: Takayasu arteritis, vasculitis, heart failure
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References
Takayasu M. A case with unusual changes of the central vessels
in the retina. Acta of the Ophthalmic Society of Japan
;12:554–55.
Arend WP, Michel BA, Bloch DA, et al. The American College
of Rheumatology 1990 criteria for the classification of
Takayasu arteritis. Arthritis Rheum 1990;33:1129–1134.
Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a
review. J Clinical Pathology 2002;55(7):481–486.
Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, et al.
Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J
;93(1):94–103.
Bicakcigil M, Aksu K, Kamali S, et al. Takayasu’s arteritis
in Turkey–clinical and angiographic features of 248 patients.
Clin Exp Rheumatol 2009;27:S59–64.
Subramanyan R, Joy J, Balakrishnan KG. Natural history
of aortoarteritis (Takayasu’s disease). Circulation 1989;80(3):
–37.
Talwar KK, Kumar K, Chopra P, et al. Cardiac involvement in
nonspecific aortoarteritis (Takayasu’s arteritis). Am Heart J
;122:1666–1670.
Ishikawa K. Natural history and classification of occlusive
thromboaortopathy (Takayasu’s disease). Circulation 1978;
:27–35.
Sharma BK, Sagar S, Singh AP, et al. Takayasu arteritis in
India. Heart Vessels Suppl 1992;7:37–43.
Lee GY, Jang SY, Ko SM, et al. Cardiovascular manifestations
of Takayasu arteritis and their relationship to the disease
activity: analysis of 204 Korean patients at a single center.
International J Cardiology 2012;159:14–20.
Arnaud L, Haroche J, Limal N, et al. Takayasu arteritis in
France: a single-center retrospective study of 82 cases comparing
white, North African, and black patients. Medicine
(Baltimore) 2010;89:1–17.
Hall S, Barr W, Lie JT, et al. Takayasu arteritis. A study of 32
North American patients. Medicine (Baltimore) 1985;64:89–99.
Seyahi, E. Takayasu arteritis: an update. Current Opinion
Rheumatology. 2017;29:51–56.
Liang P, Tan-Ong M, Hoffman GS. Takayasu’s arteritis: vascular
interventions and outcomes. J Rheumatology. 2004;
(1):102–106.
Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis.
Ann Intern Med. 1994;120:919–29.
Ishikawa K, Maetani S. Long-term outcome for 120 Japanese
patients with Takayasu’s disease. Clinical and statistical analyses
of related prognostic factors. Circulation 1994;90(4):1855–60.
Fields CE, Bower TC, Cooper LT, et al. Takayasu’s arteritis:
operative results and influence of disease activity. J Vasc Surg
;43(1):64–71.
Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis
of surgery versus endovascular intervention in Takayasu
arteritis: a multicenter experience. Circulation 2012;125(6):
–9.
T. Miyata, O. Sato, H. Koyama, H. et al. Long-term survival
after surgical treatment of patients with Takayasu’s arteritis.
Circulation 2003;108:1474–1480.
