Figure
5.follow-up ECG conducted after 6 months, illustrating premature
ventricular contractions (PVCs).
Discussion :
Aortitis, characterized by inflammation of the aorta, is a condition
with the potential for life-threatening consequences. The diagnostic
exploration of aortitis is guided by a differential diagnosis that
categorizes causes into inflammatory and infectious origins. The
principal contributors to non-infectious aortitis are the large-vessel
vasculitis, specifically giant-cell arteritis and Takayasu arteritis,
affecting the aorta and its primary branches (6).
Takayasu Arteritis (TA), a rare form of vasculitis, primarily affects
large vessels, such as the aorta and its main branches. While classic
presentations include limb claudication, reduced or absent pulses, and
vascular bruits, TA can also manifest in unusual ways, adding complexity
to its diagnosis and management (7).
One of the less common manifestations of TA is renal involvement, which
may present as renovascular hypertension due to renal artery stenosis.
This can lead to significant morbidity if not recognized and managed
promptly (7). Another atypical presentation is neurological symptoms,
ranging from headaches and dizziness to more severe complications like
strokes or transient ischemic attacks, attributed to the involvement of
carotid or vertebral arteries (8).
Gastrointestinal (GI) involvement, although rare, is another unusual
manifestation of TA. Patients may experience abdominal pain, ischemic
bowel disease, or even acute abdomen, often resulting from mesenteric
artery stenosis or aneurysms (9). Pulmonary artery involvement can also
occur, leading to symptoms like dyspnoea, chest pain, or haemoptysis.
Cardiac manifestations, including aortic regurgitation, coronary artery
disease, and myocardial infarction, are also reported in TA patients,
posing significant risks (10).
These atypical manifestations highlight the need for a high index of
suspicion and comprehensive evaluation in patients with TA. A
multidisciplinary approach involving rheumatologists, cardiologists,
neurologists, and other specialists is often necessary for optimal
management. Understanding and recognizing these unusual presentations
are crucial for early diagnosis and treatment, which can significantly
alter the disease course and improve patient outcomes (10).
References :
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- Kerr, Gail S., et al. “Takayasu arteritis.” Annals of internal
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