Angina instável devida a comunicação entre artéria coronária e artéria pulmonar direita em paciente com arterite de Takayasu

Viecili, Paulo Ricardo Nazário; Pamplona, David; Cesena, Fernando Henpin Yue; Luz, Protásio Lemos da

doi:10.1590/s0066-782x1997000800009

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…We should point out that several ethnic groups have different HLA alleles associated with TA. Patients with these HLA have a tendency to an accelerated in addition to the coronary arteries [3][4][5] .…”

Section: Discussionmentioning

confidence: 99%

“…In August, 26th, 2002, the patient underwent a successful Takayasu arteritis (TA) is a chronic vasculitis which affects especially the aorta and its main branches, resulting in varied ischemic symptoms due to stenotic lesions or thrombus formation [1][2][3][4][5][6] . Percutaneous treatment with stent implantation is feasible for the correction of stenoses of the coronary and carotid arteries, as well as of peripheral lesions, and has been increasingly considered in the management of Takayasu arteritis [7][8][9][10] .…”

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Tratamento percutâneo multivaso da Arterite de Takayasu

Tumelero¹,

Duda²,

Tognon³

et al. 2006

Arq. Bras. Cardiol.

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Takayasu arteritis, indian, stent, intravascular ultrasound, extracardiac interventional.The chest radiograph showed enlarged cardiac silhouette, elongated and dilated ascending aorta, with no signs of pulmonary congestion.Laboratory tests showed: BUN 53mg/dl (15-45), creatinine 1.39mg/dl (0.6-1.4), erythrocyte sedimentation rate (ESR) 101mm/h (10-20mm/h), C-reactive protein 30 (up to 6.0), mucoprotein tyrosine 8.8 mg/dl (1.7 a 5.1).Carotid ultrasound revealed diffuse and extensive thickening of the walls, causing a 70% stenosis of the lumen of the left common carotid artery.Takayasu disease was suspected, and to confirm the hypothesis of other arterial lesions the patient underwent coronary angiography, aortography, and peripheral arteriography, which demonstrated normal coronary arteries, severe lesion in the left common carotid artery, mild lesion in the right common carotid artery, occlusion in the proximal third of the left subclavian artery, a 60% lesion in the ostium of the right renal artery, severe lesion in the ostium of the left renal artery, and occlusion in the proximal third of the left iliac artery. Left ventricle with diffuse hypokinesia and ejection fraction (EF) of 33% were observed. The aortography showed ectasia of the aorta and moderate to severe aortic regurgitation (Fig. 2).In August, 26th, 2002, the patient underwent a successful Takayasu arteritis (TA) is a chronic vasculitis which affects especially the aorta and its main branches, resulting in varied ischemic symptoms due to stenotic lesions or thrombus formation [1][2][3][4][5][6] . Percutaneous treatment with stent implantation is feasible for the correction of stenoses of the coronary and carotid arteries, as well as of peripheral lesions, and has been increasingly considered in the management of Takayasu arteritis 7-10 . Case reportTwenty-five-year-old female Indian patient, born in and coming from an Indian reserve of the Kaingang tribe. She sought medical attention with a complaint of severe holocranial headache, accompanied by nausea and vomiting. In August, 2002 the patient had an episode of acute pulmonary edema (APE); she sought medical attention and was diagnosed with systemic hypertension (SH). She was referred for investigation of the possible causes of APE.Physical examination revealed a patient in good general conditions. Cardiac auscultation showed regular rhythm and a grade 3/6 diastolic murmur of regurgitation in the aortic area. Pulmonary auscultation showed decreased breath sounds. Reduced left carotid pulse and water-hammer radial pulse in the right upper extremity were observed. The left radial, brachial, dorsalis pedis and posterior tibial pulses were not palpable. Blood pressure (BP) was 200x40 mmHg in the right arm, and it could not be measured in the left arm due to the absence of pulse. Bilateral carotid systolic murmur with fremitus on the right side, right femoral artery murmur and abdominal murmur were detected. The funduscopy revealed arteriolar narrowing, increased arteriolar reflex and pathologic arteri...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Tratamento percutâneo multivaso da Arterite de Takayasu

Tumelero¹,

Duda²,

Tognon³

et al. 2006

Arq. Bras. Cardiol.

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Takayasu's arteritis: management of left main stem stenosis

Malik

Harare²,

Al-Nahhas³

et al. 2003

Heart

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Takayasu arteritis is a chronic vasculitis involving the aorta and its main branches, the pulmonary arteries, and the coronary tree, and needs to be considered in a young patient with angina, in particular when pulses are absent. This case illustrates the limitations of exercise testing in diagnosing the extent of coronary artery disease and the risks associated with coronary angiography in patients with inflammatory disease in the left main stem coronary artery. It also highlights the novel use of non-invasive scanning with positron emission tomography using 18-fluorodeoxyglucose in assessing remission from this disease. Revascularisation was performed with percutaneous transluminal coronary angioplasty and stenting as an emergency procedure, but treatment of the restenosis with directional atherectomy was based on a review of the available literature. The lymphocytic alveolitis seen in this patient has not been previously described in Takayasu's disease.

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Angina instável devida a comunicação entre artéria coronária e artéria pulmonar direita em paciente com arterite de Takayasu

Cited by 2 publications

References 17 publications

Tratamento percutâneo multivaso da Arterite de Takayasu

Tratamento percutâneo multivaso da Arterite de Takayasu

Takayasu's arteritis: management of left main stem stenosis

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