Abstract
Background: Takayasu arteritis (TAK) is a rare, chronic, idiopathic large-vessel vasculitis that primarily affects the aorta and its major branches. It commonly presents in young women of childbearing age with nonspecific systemic symptoms and vascular complications such as absent pulses, hypertension, and claudication. Diagnosis is challenging and relies heavily on imaging studies, as laboratory markers are nonspecific. Management typically includes high-dose corticosteroids and immunosuppressive agents, with biologic therapies and vascular interventions reserved for refractory or severe cases.
Objective: To report a rare case of a young post-partum patient diagnosed with Takayasu arteritis, complicated by heart failure, highlighting notable vascular abnormalities.
Case presentation: A 21-year-old female was admitted with symptoms of acute decompensated heart failure, initially attributed to peripartum cardiomyopathy. During hospitalization, she developed severe abdominal pain and cardiovascular instability with an absent left radial pulse. Further evaluation led to a diagnosis of Takayasu arteritis with multi-vessel involvement. Treatment with standard heart failure therapy and high-dose corticosteroids with immunosuppressive therapy resulted in improved cardiac function.
Conclusion: This case underscores the complexity of diagnosing and managing a 21-year-old female with concurrent Takayasu arteritis and acute decompensated heart failure. It highlights the critical need for early identification and comprehensive evaluation of cardiovascular conditions in post-partum patients, as timely intervention can lead to significant improvements in outcomes. The successful treatment and positive response to therapy in this case reinforce the importance of adhering to guideline-directed medical therapy.
Keywords
Takayasu arteritis, Peripartum cardiomyopathy, Vasculitis, Heart failure, Paroxysmal nocturnal dyspnea.
Introduction
TAK is a rare inflammatory condition affecting the aorta and its branches. 1 It causes inflammation, leading to artery narrowing, blockage, or weakening. This can result in various symptoms, including fever, fatigue, high blood pressure, weak pulses, claudication, visual disturbances, headaches, and heart failure. 2,3 A systematic review and meta-analysis estimated the global incidence at approximately 1.11 per million person-years (95% confidence interval (CI) 0.70–1.76), with a notably higher incidence in women, approximately 2.01 per million person-years (95% CI 1.39–2.90). 4 Diagnosis involves blood tests and imaging studies. 5 Treatment focuses on reducing inflammation with medications like corticosteroids and immunosuppressants and may include surgery for severe cases, such as angioplasty, stent placement, or aneurysm repair. 6 Early diagnosis and treatment are crucial for managing this serious condition.
We present a case of a patient with Takayasu arteritis and describe the clinical presentation, treatment, and outcomes.
