Takayasu's arteritis (disease, Takayasu syndrome) is difficult to diagnose because its symptoms vary widely and are associated with completely different diseases. And the later the disease is diagnosed, the risk of blood vessel obstruction increases, which can result in a stroke, heart attack or even death. What are the causes and symptoms of Takayasu's disease? What is its treatment?

Takayasu's disease , otherwiseTakayasu's arteritisorPulseless diseaseor Takayasu's syndrome , is inflammation of arterial vessels - the large arteries that extend from the aortic arch (the main artery that supplies blood to the entire body) and also, slightly less frequently, from the abdominal aorta. As a result of the inflammation that develops in the vessel wall, it causes segmental narrowing of the vessels. In these places, clots form, which can not only block the vessels in place, but also break loose and block the vessels further where they are narrower. The consequence of this process is ischemia of the tissues supplied by these vessels and the associated effects (e.g. myocardial infarction, ischemic stroke).

Takayasu's disease belongs to the group of systemic connective tissue diseases (rheumatic diseases) and mainly affects young women aged 10-40 years. Men get sick 10 times less often than women. It is estimated that in Europe and the USA there are 1-3 new cases per million inhabitants per year. The disease is most often diagnosed in Asian countries.

Takayasu's disease - causes

The causes of Takayasu's disease are unknown. It is suspected to be of genetic origin. In genetically burdened people, pathological immune reactions are triggered. The cells of the immune system then attack the aortic wall and its branches, causing inflammation.

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Takayasu's disease - symptoms

The symptoms of Takayasu's disease vary greatly, depending on the phase of disease and the location of the vessel involved.

In the first stage of the disease, usually many months before the onset of local symptoms, patients may complain of general symptoms such as fever or low-grade fever, headache, dizziness, sweating,vision, paresthesia (cold, numbness, tingling in the limbs) and joint pain.

In the second stage of the disease, local symptoms appear, which depend on the location of the vessel involved:

  • subclavian artery - weakness of the upper or lower limbs, claudication (pain during exercise) of the upper limbs;
  • common carotid artery - dizziness and headaches, fainting, visual disturbances (this is related to impaired blood supply to the brain);
  • vertebral artery - dizziness, visual disturbances;
  • abdominal aorta - abdominal pain, nausea, vomiting;
  • renal artery - arterial hypertension associated with the narrowing of the renal arteries, chronic renal failure;
  • pulmonary artery - shortness of breath, haemoptysis, chest pain (pulmonary hypertension rarely develops);
  • aortic arch - congestive heart failure, aortic valve regurgitation;
  • coronary artery - chest pain radiating to the lower jaw or left upper limb and other symptoms of myocardial ischemia, e.g. arrhythmias;
  • visceral trunk - abdominal pain, nausea, vomiting, diarrhea;
  • arterial vessels of the retina - visual disturbances that may lead to blindness.

In the course of the disease, there may be a loss of heart rate in the artery affected by the disease (hence the disease without a pulse). Lack of heart rate is the result of an arterial narrowing or closure that prevents or weakens the pulse wave.

Important

The classification criteria for Takayasu's disease (according to the American College of Rheumatology, 1990) are important during the diagnosis. 3 out of 6 points are enough for recognition: 1. Disease onset under the age of 40 2. Lars of any limb, especially the upper limb 3. Weakening of the pulse in the brachial artery. 4. Differences between blood pressure values ​​on both arms>10 mm Hg. 5. A murmur heard over the subclavian artery or abdominal aorta. 6. Abnormal arteriogram (aortic stenosis, narrowing or closure of its main branches or proximal arteries of the limbs; changes of a segmental or focal nature).

Takayasu's disease - diagnosis

Takayasu's disease diagnosis includes tests such as:

  • blood tests (elevated ESR may be an illness);
  • Chest X-ray - may reveal aortic dilatation;
  • computed tomography or magnetic resonance imaging allows you to visualize the thickened walls of the aorta and its branches;
  • ultrasonography (USG) - the test allows for the detection of narrowing of the vessels and blood flow disorders;

Final recognition putsbased on the results of angiography, which shows a vasoconstrictor lesion and is therefore the most sensitive test.

Takayasu's disease - treatment

In the early stage of the disease, treatment consists of administering glucocorticosteroids (which is associated with various complications) or immunosuppressive drugs. If the patient has already had vasoconstriction, surgery is performed to restore them. In the event of a failure of the procedure, surgeons may decide to perform the so-called bypassing the vessels, i.e. by-passes.

Category:

Cardiology