Takayasu Arteritis as an Odd Cause of Chest Pain

Santiago Bernal-Macias, Maria A. Alzate, Adriana Rojas-Villarraga

Abstract


We describe a case of Takayasu arteritis with unusual presentation, having chest pain as the main symptom and a nasal septal perforation as a rare complication, without upper and lower extremities, abdominal, neck or cerebral compromise. The patient, a 34 year-old male, previously healthy, presented with acute onset of chest pain, dyspnea and severe compromise of his functional status. Severe stenosis of pulmonary arteries and coronaries, as well as signs of aortitis were found in a CT angiography of the thorax, pulmonary angiography and right and left heart catheterization. Anti-neutrophil cytoplasmic antibodies were positive. The patient received 750 mg of Methylprednisolone and monthly bolus of Cyclophosphamide. Six months after the diagnosis, the patient developed a nasal septal perforation. This is the first reported case of Takayasu arteritis with rapidly progressing coronary disease as the only presentation, complicated by a nasal septal perforation. 


Keywords


Takayasu arteritis, vasculitis, vascular disease, coronary artery disease

Full Text:

PDF

References


Cañas CA, Jimenez CA, Ramirez LA, Uribe O, Tobón I, Torrenegra A, et al. Takayasu arteritis in Colombia. Int J Cardiol. 1998;66 Suppl 1:S73–9.

Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford). 2014;53:793–801.

Duque B, Raimundo A, Appleton T, Pereira F, Roquette J, Sá J. Arterite de Takayasu : a propósito de um caso clínico. Rev Port Cardiol. 2015;34:1–4.

Mukhtyar C, Guillevin L, Cid MC, Dasgupta B, de Groot K, Gross W, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2009 Mar;68:318–23.

Waller R, Mrcp M, Ahmed A, Chb MB, Patel I, Mrcp M, et al. Update on the classification of vasculitis. Best Pract Res Clin Rheumatol. 2013;27:3–17.

Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2 DOI: 10.17987/icfj.v2i1.4




DOI: https://doi.org/10.17987/icfj.v6i0.192

Copyright (c) 2016 Santiago Bernal-Macias, Maria A. Alzate, Adriana Rojas-Villarraga

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.