cardiovascular-agents and Takayasu-Arteritis

The guidelines for medical treatment of Takayasu arteritis established in 1987 by the Systemic Vascular Disorders Research Committee, Ministry of Health and Welfare of Japan are presented. The first part of the guidelines concerns treatment with adrenocorticosteroids and the second part concerns other medical treatment. A review of the literature referring to steroid therapy and other medical treatment of Takayasu arteritis is also included.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Cardiovascular Agents; Humans; Hypertension; Immunosuppressive Agents; Prednisolone; Takayasu Arteritis

A 27-year-old male patient suffering from dizziness and right amaurosis was diagnosed with Takayasu arteritis (TA). Computed tomography angiography showed that all the supra-aortic arteries were occluded except an aberrant right subclavian artery. The patient underwent drug-coated balloon dilatation at the lesion of the right common carotid artery and performed well after the procedure. Six months later, the patient's symptoms have not recurred and computed tomography angiography showed the right carotid artery remains patency. The supra-aortic artery lesions in TA may be a potential novel indication for a drug-coated balloon.

Topics: Adult; Angioplasty, Balloon; Cardiovascular Agents; Carotid Artery, Common; Carotid Stenosis; Humans; Male; Paclitaxel; Takayasu Arteritis; Treatment Outcome; Vascular Access Devices; Vascular Patency

Takayasu arteritis (TA), a systemic vasculitis typically occurring in female patients aged ≤40, can affect coronary arteries and cause ischemic heart disease (IHD). In this study, we investigated the prevalence of TA in young women presenting with IHD in the Emergency Department.. We evaluated hospital records of 158,860 consecutive female patients aged <40, who accessed the Emergency Department of our institution over 8 consecutive years (2007-2015). The prevalence of different etiologies of IHD was determined. Diagnosis of TA was established based on the 1990 ACR criteria.. Overall, 1950 women aged <40 presented to the Emergency Department with chest pain, dyspnea, palpitations, angina, heart failure, or cardiac arrest; 40 had acute IHD. The etiology was 'classic' atherosclerosis in 24 cases (60%), TA in 4 cases (10%), vasospasm and sympathomimetic drug abuse in 3 cases each (7.5%), coronary artery dissection and microvascular angina in 2 cases each (5%), Takotsubo and radiation-induced cardiomyopathy in 1 case each (2.5%).. Although a diagnosis of TA is likely to be overlooked, TA is not infrequent in younger females presenting with acute IHD, a finding relevant to the diagnosis and management of these patients.

Topics: Acute Disease; Adult; Cardiovascular Agents; Chest Pain; Emergency Medical Services; Female; Humans; Myocardial Ischemia; Prevalence; Takayasu Arteritis

Topics: Adult; Cardiovascular Agents; Female; Giant Cell Arteritis; Humans; Immunosuppressive Agents; Male; Polyarteritis Nodosa; Syndrome; Systemic Vasculitis; Takayasu Arteritis; Thromboangiitis Obliterans; Vasculitis

Takayasu arteritis is an inflammatory condition that involves the large cardiac vessels, predominantly the aorta and its main branches. It typically affects young women (age, ≤40 yr), most often Asians and Latin Americans. Herein, we describe a rare manifestation of Takayasu arteritis in a 19-year-old black Tunisian man who presented with acute inferior myocardial infarction and complete atrioventricular block after occlusion from a giant aneurysm in the right coronary artery. The coronary artery disease was associated with aneurysmal dilations in the carotid, vertebral, and right renal arteries. Medical therapy improved Thrombolysis in Myocardial Infarction flow in the area of the giant aneurysm from grade 1 to grade 3. Upon the diagnosis of Takayasu arteritis, intravenous methylprednisolone and oral prednisone therapy was started. After 10 days of hospitalization, the patient was discharged on a medical regimen. Renovascular hypertension due to renal artery stenosis was suspected, so he underwent successful percutaneous transluminal angioplasty of the inferior segmental artery of the right renal artery. During 12 months of close postprocedural monitoring, he experienced lower blood pressure, no chest pain, and no cardiovascular complications.This association of conditions has not been previously reported. Besides presenting this very rare combination of findings, we discuss the differential diagnosis of Takayasu arteritis in our patient.

Topics: Angioplasty, Balloon; Atrioventricular Block; Cardiovascular Agents; Coronary Aneurysm; Coronary Angiography; Diagnosis, Differential; Electrocardiography; Glucocorticoids; Humans; Male; Myocardial Infarction; Predictive Value of Tests; Renal Artery Obstruction; Stents; Takayasu Arteritis; Treatment Outcome; Young Adult

Takayasu arteritis is a chronic, progressive, autoimmune, idiopathic, large-vessel vasculitis that usually affects young adults. The disease has been reported to occur in all races and ethnicities. The diffuse nature of this vasculitis can affect multiple-organ systems to varying degrees. Herein, we report the case of a young woman whose exertional angina and claudication were the initial presentation of active Takayasu arteritis. During more than 4 years of ongoing treatment, therapy, and follow-up, she has displayed differing disease symptoms of varying intensity. We discuss the challenges of managing Takayasu arteritis in our patient and describe different treatments for this rare vasculitic disorder.

Topics: Adult; Angina Pectoris; Aortography; Arterial Occlusive Diseases; Cardiovascular Agents; Combined Modality Therapy; Coronary Angiography; Coronary Artery Bypass; Coronary Stenosis; Exercise Test; Female; Humans; Immunosuppressive Agents; Intermittent Claudication; Magnetic Resonance Angiography; Severity of Illness Index; Takayasu Arteritis; Treatment Outcome