Bengal Physician Journal

Register      Login

VOLUME 8 , ISSUE 1 ( January-April, 2021 ) > List of Articles

CASE REPORT

Ischemic Cardiomyopathy in a Case of Takayasu's Arteritis

Sourav Mukherjee, Souvik Samanta, Upoma Saha, Srijib Pal, Sujoy Sarkar, Salil K Pal

Keywords : Heart failure, Steroid, Vasculitis

Citation Information : Mukherjee S, Samanta S, Saha U, Pal S, Sarkar S, Pal SK. Ischemic Cardiomyopathy in a Case of Takayasu's Arteritis. Bengal Physician Journal 2021; 8 (1):17-20.

DOI: 10.5005/jp-journals-10070-7039

License: CC BY-NC 4.0

Published Online: 17-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

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 Department of Medicine of Calcutta National Medical College and Hospital, Kolkata, West Bengal, India. On initial examination, the patient had absent pulses in all four limbs, and the patient's blood pressure (BP) was not recordable. Clinical examination also revealed features of biventricular failure. Relevant routine investigations like electrocardiogram (ECG), two-dimensional Doppler electrocardiography (2D-Echo), cardiac markers, and blood parameters were done. 2D-Echo was suggestive of ischemic cardiomyopathy. Considering the patient's physical findings along with raised erythrocyte sedimentation rate (ESR), further investigations like CT angiography (CTA) were done, which led to the diagnosis of TA. The patient was treated with oral steroid, diuretic, beta-blocker, and antiplatelet and then discharged in a stable condition.


HTML PDF Share
  1. American College of Physicians (ACP). Systemic vasculitis. Medical knowledge self-assessment program (MKSAP-15): rheumatology. Philadelphia, PA: ACP, 2009, pp. 65–67.
  2. Espinoza JL, Ai S, Matsumura I. New insights on the pathogenesis of Takayasu arteritis: revisiting the microbial theory. Pathogens. 2018;7:73. DOI: 10.3390/pathogens7030073.
  3. Arora P, Kher V, Singhal MK, et al. Renal arterystenosis in nonspecific aortoarteritis: spectrum of disease in children and adults. Kidney Blood Press Res 1997;20:285–289. DOI: 10.1159/000174160.
  4. Jain S, Kumari S, Ganguly NK, et al. Current status of Takayasu Arteritis in India. Int J Cardiol 1996; 54(Suppl): S111–S116. DOI: 10.1016/s0167-5273(96)88780-8.
  5. De Souza AW, de Carvalho JF. Diagnostic and classification criteria of Takayasu arteritis. J Autoimmun 2014;48–49:79–83. DOI: 10.1016/j.jaut.2014.01.012.
  6. 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(8):1129–1134. DOI: 10.1002/art.1780330811.
  7. Duzova A, Turkmen O, Cinar A, et al. Takayasu arteritis and tuberculosis: a case report. Clin Rheumatol 2000;19:486–489. DOI: 10.1007/s100670070013.
  8. Sun T, Zhang H, Ma W, et al. Coronary artery involvement in Takayasu arteritis in 45 Chinese patients. J Rheumatol 2013;40:493–497. DOI: 10.3899/jrheum.120813.
  9. Matsubara O, Kuwata T, Nemoto T, et al. Coronary artery lesions in Takayasu arteritis: pathological considerations. Heart Vessels Suppl 1992;7:26–31. DOI: 10.1007/bf01744540.
  10. Ghosh S, Sinha DP, Ghosh S, et al. Dilated cardiomyopathy in non specific aortoarteritis. Indian Heart J 1999;51:527–531. PMID: 10721644
  11. Nakaoka Y, Isobe M, Takei S, et al. Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study). Ann Rheum Dis 2018;77(3):348–354. DOI: 10.1136/annrheumdis-2017-211878.
  12. Unizony S, Stone JH, Stone JR. New treatment strategies in large-vessel vasculitis. Curr Opin Rheumatol 2013;25(1):3–9. DOI: 10.1097/BOR.0b013e32835b133a.
  13. Yokoe I, Haraoka H, Harashima H. A patient with Takayasu's arteritis and rheumatoid arthritis who responded to tacrolimus hydrate. Intern Med 2007;46(22):1873–1877. DOI: 10.2169/internalmedicine.46.0211.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.