Takayasu arteritis with congestive heart failure in 26-year-old male: a case report
Abstract Background Takayasu arteritis (TA) is included in large vessel vasculitis with unknown aetiopathogenesis. TA is one of the rare diseases with a predilection for young women. The diagnosis of TA is difficult due to variation in clinical presentations and non-specific initial symptoms. This c...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-05-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-022-00279-5 |
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| author | Suryono Suryono Pipiet Wulandari Dwi Ariyanti Aditha Satria Maulana R. Handi Sembodo Narendra Wahyu Junior Antonius Dwi Saputra |
| author_facet | Suryono Suryono Pipiet Wulandari Dwi Ariyanti Aditha Satria Maulana R. Handi Sembodo Narendra Wahyu Junior Antonius Dwi Saputra |
| author_sort | Suryono Suryono |
| collection | DOAJ |
| description | Abstract Background Takayasu arteritis (TA) is included in large vessel vasculitis with unknown aetiopathogenesis. TA is one of the rare diseases with a predilection for young women. The diagnosis of TA is difficult due to variation in clinical presentations and non-specific initial symptoms. This case demonstrates rare TA in a young male with congestive heart failure as the predominant manifestation. Case presentation We report a 26-year-old male presented with severe dyspnea, palpitation, orthopnea, paroxysmal nocturnal dyspnea, and claudication in the left arm. Four limbs blood pressure discrepancy was present. Chest X-ray showed cardiomegaly with calcification aortic arch and pulmonary edema. Echocardiography revealed that left ventricular ejection fraction decreased with severe aortic and mitral valve regurgitation. Computed tomography angiography showed stenosis of the left common carotid artery and total occlusion of the left subclavian artery with collateral artery. There was vascular thickness and calcification from the peri-aortic valve, ascending aorta, aortic arch, and thoracic descending aorta until abdominal aorta with high-grade stenosis on the inferior side of the renal artery branching accompanied by a post-stenotic dilatation. Conclusions This patient’s heart failure was precipitated by secondary hypertension and aortic regurgitation caused by vasculitis of TA. In general, there is no difference in the management of congestive heart failure in patients with TA. Optimized pharmacology therapy with combination steroid and methotrexate successfully inducing remission of TA after 3-months follow-up. |
| first_indexed | 2024-04-13T18:17:30Z |
| format | Article |
| id | doaj.art-f9de1287f9434fac9c14a296c84168af |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-13T18:17:30Z |
| publishDate | 2022-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-f9de1287f9434fac9c14a296c84168af2022-12-22T02:35:37ZengSpringerOpenThe Egyptian Heart Journal2090-911X2022-05-017411610.1186/s43044-022-00279-5Takayasu arteritis with congestive heart failure in 26-year-old male: a case reportSuryono Suryono0Pipiet Wulandari1Dwi Ariyanti2Aditha Satria Maulana3R. Handi Sembodo4Narendra Wahyu Junior5Antonius Dwi Saputra6Departement of Cardiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalDepartement of Cardiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalDepartement of Cardiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalDepartement of Cardiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalDepartement of Radiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalDepartement of Radiology, Faculty of Medicine, University of Jember - Dr. Soebandi General HospitalFaculty of Medicine, University of JemberAbstract Background Takayasu arteritis (TA) is included in large vessel vasculitis with unknown aetiopathogenesis. TA is one of the rare diseases with a predilection for young women. The diagnosis of TA is difficult due to variation in clinical presentations and non-specific initial symptoms. This case demonstrates rare TA in a young male with congestive heart failure as the predominant manifestation. Case presentation We report a 26-year-old male presented with severe dyspnea, palpitation, orthopnea, paroxysmal nocturnal dyspnea, and claudication in the left arm. Four limbs blood pressure discrepancy was present. Chest X-ray showed cardiomegaly with calcification aortic arch and pulmonary edema. Echocardiography revealed that left ventricular ejection fraction decreased with severe aortic and mitral valve regurgitation. Computed tomography angiography showed stenosis of the left common carotid artery and total occlusion of the left subclavian artery with collateral artery. There was vascular thickness and calcification from the peri-aortic valve, ascending aorta, aortic arch, and thoracic descending aorta until abdominal aorta with high-grade stenosis on the inferior side of the renal artery branching accompanied by a post-stenotic dilatation. Conclusions This patient’s heart failure was precipitated by secondary hypertension and aortic regurgitation caused by vasculitis of TA. In general, there is no difference in the management of congestive heart failure in patients with TA. Optimized pharmacology therapy with combination steroid and methotrexate successfully inducing remission of TA after 3-months follow-up.https://doi.org/10.1186/s43044-022-00279-5Takayasu arteritisCongestive heart failureEchocardiographyComputed tomography angiographyCase report |
| spellingShingle | Suryono Suryono Pipiet Wulandari Dwi Ariyanti Aditha Satria Maulana R. Handi Sembodo Narendra Wahyu Junior Antonius Dwi Saputra Takayasu arteritis with congestive heart failure in 26-year-old male: a case report The Egyptian Heart Journal Takayasu arteritis Congestive heart failure Echocardiography Computed tomography angiography Case report |
| title | Takayasu arteritis with congestive heart failure in 26-year-old male: a case report |
| title_full | Takayasu arteritis with congestive heart failure in 26-year-old male: a case report |
| title_fullStr | Takayasu arteritis with congestive heart failure in 26-year-old male: a case report |
| title_full_unstemmed | Takayasu arteritis with congestive heart failure in 26-year-old male: a case report |
| title_short | Takayasu arteritis with congestive heart failure in 26-year-old male: a case report |
| title_sort | takayasu arteritis with congestive heart failure in 26 year old male a case report |
| topic | Takayasu arteritis Congestive heart failure Echocardiography Computed tomography angiography Case report |
| url | https://doi.org/10.1186/s43044-022-00279-5 |
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