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

ABSTRACT

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 101. 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.