Late Diagnosis of Takayasu Arteritis with Cardiac Involvement: Case Report

Stojanović, Maja; Perić-Popadić, Aleksandra; Rašković, Sanvila; Bolpačić, Jasna; Vuckovic, Maja; Spirić, Vesna Tomić; M, Bogić

doi:10.3889/seejim.2015.20005

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…При рутинных патологоанатомических исследованиях ни аорта, ни магистральные артерии часто не подвергались микроскопическому исследованию. Описаны серии клинических наблюдений, когда поздняя диагностика заболевания была ассоциирована с риском развития тромбоза брюшного отдела аорты, повторных ишемических инсультов [19,20]. В последнее десятилетие ХХ века в Российской Федерации диагноз АТ ставился в среднем через 5 лет после появления первых симптомов -как правило, уже на этапе необратимых изменений артерий, ассоциированных с высоким риском развития сосудистых осложнений и ухудшением прогноза [25,26].…”

Section: Discussionunclassified

“…Между тем позднее направление к ревматологу и, следовательно, позднее начало адекватной терапии могут стать причиной ухудшения прогноза вследствие развития сосудистых осложнений, способных привести к стойкой утрате трудоспособности или смерти в молодом возрасте. Описаны клинические случаи, когда несвоевременная постановка диагноза приводила к таким осложнениям, как полная окклюзия брюшной аорты, множественные поражения артерий с выраженной систолической дисфункцией левого желудочка [19,20].…”

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The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

Borodina

Попов

Шардина

2021

Naučno-praktičeskaâ revmatologiâ

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Aim. To assess the effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis (TA) patients. Methods. 183 patients with TA who were treated at the Sverdlovsk Regional Clinical Hospital No. 1 during the period from 01.01.1979 to 31.04.2018 were examined. There were 139 women and 44 men included, median age at the time of diagnosis being 35 [24; 44] years in females and 34 [26.5; 42] years in males and a median interval from the first symptoms onset to the diagnosis of 3 [1; 7] and 4 [1.5; 8] years respectively. The diagnosis of TA met the ACR criteria (1990).Results. During the follow-up period, 31 deaths were observed (18 in males and 13 in females). The median age of death for women was 36 [32-44] years, for men - 50 [40-57] years. Cardiovascular complications were recorded in 72 patients (27 men and 45 women). Vascular complications and namely acute cerebrovascular accident observed in 31 (43%) patients, including ischemic stroke in 24 (35%), transient ischemic attack in 3 (3%) and hemorrhagic stroke in 4 (6%) were the most frequent. Arterial thromboses were registered in 32 (44%) cases. In 162 (88.5%) patients, the diagnosis was established more than six months after the appearance of the first symptoms.At the primary physician visit in 71 (39%) patients, the initial diagnosis was erroneous. The most common symptoms they had were regarded as a manifestation of arterial hypertension (in 18% cases). 4 years or more interval from the onset of TA symptoms to diagnosis was associated with a significant cardiovascular events odds increase (OR=1.8; 95% CI: 1.07-3.34) and premature death by the 5th year of follow-up (OR=2.9; 95% CI: 1,27-6,55).Conclusion. In the retrospective TA cohort setting, late diagnosis verification and delayed treatment initiation were associated with an increased risk of premature death and severe vascular complications, described earlier in other samplings. Timely diagnosis and as early as possible appropriate treatment administration can prevent the disease progression and disabling complications occurrence.

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The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

Borodina

Попов

Шардина

2021

Naučno-praktičeskaâ revmatologiâ

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“…Необхідно підкреслити, що рання діагностика НАА і ураження ЛА залишається складною, особливо у випадках ізольованого або початкового прояву ураження ЛА при НАА [5]. Незначна поширеність, гетерогенність, неспецифічність початкових симптомів чи асимптоматичний перебіг часто призводять до затримки встановлення діагнозу НАА і ураження ЛА [2,3,6,7,8] до розвитку у пацієнтів симптомів ЛГ, тромбозу або недостатності правих відділів серця [7] та призначення своєчасного імуносупресивного лікування [8]. Так, розвиток симптомів НАА до виявлення ЛГ складав 12,3 ± 4,8 років (6-20 років) [7], а за даними іншого дослідження, затримка у встановленні діагнозу НАА у пацієнтів віком старше 40 років становила 44,8 місяця порівняно з 28,3 місяців у пацієнтів молодше 40 років (р < 0,001) [9].…”

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PULMONARY ARTERY INFLAMMATION IN NON-SPECIFIC AORTOARTERITIS. Review

Mostbauer

Dzhus

2022

Med. Sci. of Ukr.

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Relevance. Nonspecific aortoarteritis (NAA) or Takayasu's disease can exacerbate life-threatening arteritis of the pulmonary artery (LA), which is usually diagnosed with delay and lead to a poor prognosis. Objective: to review the literature data on LA lesions in NAA to improve the diagnosis and timely appointment of appropriate treatment for better the prognosis of the overall outcome. Methods. Review of scientific literature in international electronic databases PubMed, Google Scholar by keywords for the period 2007-2022. The search was conducted by two independent authors. 90 sources were selected for analysis, of which 43 were used, which were written in English and met the search criteria. Results. In NAA, LA lesions are not a rare pathology, which is observed in 5.7-66% of cases. LA arteritis can manifest itself in the form of stenosis, occlusion, dilatation, aneurysm, thrombosis in situ, and thickening of the arteries. When LA is involved in the pathological process, the risk of developing pulmonary hypertension (LH), heart failure, and lung parenchymal lesions increases, which worsens the prognosis of such patients. The pathology of LA is often diagnosed with a delay due to nonspecific symptoms. It should be noted that in NAA LH can develop not only due to LA arteritis but also due to the presence of pathology in the left heart. Conclusions. LA lesions are common in patients with NAA, however, are often diagnosed with a delay. Involvement of LA in the pathological process can lead to the development of LH, HF, and lung parenchymal lesions and worsen the prognosis, so early diagnosis and timely appropriate treatment are important to reduce morbidity and mortality due to LA lesions in NAA. In addition, pulmonary blood flow and intracardiac hemodynamics should be monitored regularly.

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Takayasu's Arteritis and Pregnancy

Khandelwal¹

2019

Cardiac Problems in Pregnancy, 4th Edition

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Late Diagnosis of Takayasu Arteritis with Cardiac Involvement: Case Report

Cited by 3 publications

References 21 publications

The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

The effect of late diagnosis on survival and risk of vascular complications in Takayasu's arteritis patients

PULMONARY ARTERY INFLAMMATION IN NON-SPECIFIC AORTOARTERITIS. Review

Takayasu's Arteritis and Pregnancy

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