Pericardial effusion as primary manifestation of Takayasu arteritis

Fateh-Moghadam, Suzanne; Huehns, Sonja; Schmidt, Wolfgang A.; Dietz, Rainer; Bocksch, Wolfgang

doi:10.1016/j.ijcard.2008.12.133

Cited by 14 publications

(5 citation statements)

References 8 publications

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“…Echocardiography may reveal the following abnormalities: (a) left ventricular hypertrophy as arterial hypertension caused by renal artery stenosis may be missed because of subclavian artery stenoses or occlusions; (b) vasculitic wall swelling of the ascending aorta; the first 4 cm of the ascending aorta are visible with transthoracic echocardiography; (c) aortic valve insufficiency due to vasculitis of the ascending aorta; (d) pericardial effusion; (e) pulmonary hypertension due to vasculitic stenosis of the pulmonary arteries [Fateh-Moghadam et al 2010].…”

Section: Ultrasound In Takayasu Arteritismentioning

confidence: 99%

Role of ultrasound in the understanding and management of vasculitis

Schmidt

2013

Therapeutic Advances in Musculoskeletal

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Vasculitis is characterized by a circumferential vessel-wall thickening ('halo'), which can be visualized by modern imaging techniques. In particular, the resolution of ultrasound has increased to 0.1 mm. Ultrasound detects abnormalities that are pathognomonic even in arteries with a diameter below 1 mm. It is particularly helpful in the diagnosis of large-vessel vasculitides, such as classic temporal arteritis, large-vessel giant-cell arteritis (GCA), Takayasu arteritis and idiopathic aortitis. Echocardiography is important for determining cardiac involvement in Takayasu arteritis and also for examining the coronary arteries of children with suspected Kawasaki disease, which is a medium-vessel vasculitis. In small vessel vasculitides ultrasound has only a role for determining the distribution or organ involvement. Fast-track clinics for the diagnosis of GCA help to initiate treatment before complications such as blindness occur; patients receive appointments within 24 h in these clinics. Clinical examination and ultrasound of temporal and axillary arteries are performed by an experienced rheumatologist. In most cases this is able to determine if GCA is present. Temporal artery biopsy can be still carried out in ambivalent cases. The wall swelling of temporal arteries disappears after 2-3 weeks of glucocorticoid treatment. After 3 days of treatment, diagnosis becomes more difficult with ultrasound in some cases. In larger arteries, such as the axillary arteries, wall thickening disappears within months. It tends to be darker (more hypoechoic) in acute disease because of oedema.

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Section: Ultrasound In Takayasu Arteritismentioning

confidence: 99%

Role of ultrasound in the understanding and management of vasculitis

Schmidt

2013

Therapeutic Advances in Musculoskeletal

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“…This case is unique because pericardial effusion occurred during TA treatment, and AD subsequently developed. Pericardial effusion is a rare but possible characteristic of TA [9]. In ammation of the ascending aorta can result in exudative effusion in the pericardial sac [10].…”

Section: Discussionmentioning

confidence: 99%

Association between pericardial effusion and aortic dissection in a patient with endothelial damage and permeability caused by Takayasu arteritis: a case report

Mitsuishi,

Tao,

Edo

et al. 2023

Preprint

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Background Patients with Takayasu arteritis (TA) can present with aortic dissection (AD). Pericardial effusion is extremely rare in TA, and the association between pericardial effusion and progression to AD is unclear. Case presentation: We present a 51-year-old male patient who had a previous history of ulcerative colitis 20 years ago and who was treated with steroids and immunosuppressants. His fever and inflammatory reaction worsened without gastrointestinal symptoms. Based on his fluorodeoxyglucose-positron emission tomography and computed tomography scan results and clinical symptoms, he was diagnosed with TA. Eight days before surgery, the patient developed complete atrioventricular block, and a pacemaker was placed. Coronary artery computed tomography scan was performed to closely examine the coronary arteries. Ascending AD was discovered incidentally, and ascending aortic replacement was performed. Conclusions Some patients with TA exhibited high levels of vascular endothelial growth factor (VEGF), which was produced as a result of endothelial damage associated with disease activity. Patients showed high disease activity soon after the diagnosis of TA. VEGF increases vascular permeability and can cause pericardial effusion, similar to AD pathogenesis. As intimal rupture is one of the initial events of AD, changes in the intimal structure result in endothelial cell dysfunction, thereby increasing vascular endothelial permeability, which is a mechanism of pericardial effusion in AD. Pericardial effusion in AD is an ominous clinical predictor of poor outcomes and is the leading cause of mortality. Because TA with pericardial effusion may have a similar pathogenesis and vascular condition in AD, caution should be exercised when pericardial effusion is noted in patients with TA, which could be a sign of high vascular activity that possibly progresses to AD, especially immediately after diagnosis. Hence, cautious follow-up via computed tomography may be useful.

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“…According to a study conducted by Fateh-Moghadam et al, only four instances of pericardial effusion associated with TA have been documented thus far [ 28 ]. Although angiography has traditionally been the conventional diagnostic approach, there has been a shift towards adopting less invasive techniques such as CT angiography and magnetic resonance angiography (MRA).…”

Section: Reviewmentioning

confidence: 99%

Exploring Cardiovascular Manifestations in Vasculitides: An In-Depth Review

Vats,

Patel,

Sharma

et al. 2023

Cureus

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Systemic vasculitides encompass a cluster of autoimmune diseases that affect blood vessels, and are characterized by immune-mediated injury to either small- or large-sized blood vessels. Individuals afflicted with systemic vasculitides experience notable morbidity and mortality attributable to cardiovascular manifestations. Noteworthy among these are ischemic heart disease, venous thromboembolism, aortic involvement, valvular irregularities, myocarditis, and pericarditis. This narrative review investigated and evaluated the prevalent cardiovascular disturbances commonly associated with different types of vasculitides. This review also discusses the mechanisms that underlie these manifestations. It also provides a thorough explanation of the many diagnostic techniques essential for detecting the disease at its occult stage. It is essential for healthcare professionals to have knowledge of the cardiovascular complications caused by vasculitides, as this enables them to promptly recognize these symptoms and employ suitable diagnostic techniques early on. By doing so, timely detection can be ensured, which will subsequently aid in initiating appropriate treatment strategies that are vital for decreasing morbidity and mortality in patients with systemic vasculitides.

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Pericardial effusion as primary manifestation of Takayasu arteritis

Cited by 14 publications

References 8 publications

Role of ultrasound in the understanding and management of vasculitis

Role of ultrasound in the understanding and management of vasculitis

Association between pericardial effusion and aortic dissection in a patient with endothelial damage and permeability caused by Takayasu arteritis: a case report

Exploring Cardiovascular Manifestations in Vasculitides: An In-Depth Review

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