Analysis Of Takayasu’s Arteritis In Main Manifestations Of Recurrent Chest Pain

Objective:Takayasu’s arteritis (TA) is a chronic nonspecific vasculitis of unknown etiology affecting aorta and its main branches, coronary and pulmonary arteries which can cause different parts of the vascular stenosis or occlusion, a few can cause blood vessels to dilate or aneurysm formation. This article aims to make a comprehensive understanding of the disease etiology, pathogenesis, the clinical manifestations, diagnosis and treatment strategies of Takayasu’s arteritis through reporting a very complicated case, to further improve the diagnosis rate.Methods:Collected the history, physical examination, laboratory and imaging studies of one complicated case of Takayasu’s arteritis of our hospital Cardiology in April 2014, combined with the database search on the pubmed, to summarize the diagnosis and treatment of Takayasu’s arteritis.Results:In this case, the patient had recurrent chest pain, right upper limb no pulse, blood pressure can not be measured, the apex could be heard and grade 3/6 systolic whole systolic murmur hair samples, both lower extremities dorsal artery weaker. With the the CTA and Three-dimensional reconstruction of Coronary and Thoracoabdominal aorta, the patient was diagnosed as Takayasu’s arteritis that involved the right internal iliac artery, superior mesenteric artery, the right renal artery, thoracic aorta, coronary arteries (left anterior descending, left circumflex artery). TA often involved multiple systemic vascular disease, but the patients which involved the coronary arteries cause recurrent chest pain as the main manifestation is relatively rare in clinical practice. The patient’s previous symptom of recurrent chest pain vanished after drugs of corticosteroids and immunosuppressive to control inflammation and secondary prevention treatment of coronary atherosclerotic heart disease.Conclusions:Takayasu’s arteritis is a chronic nonspecific inflammation mainly involving the aorta and its main branches which become prone to misdiagnosis or missed diagnosis since the early symptoms are not typically. TA should be differentiated from coronary atherosclerosis caused by coronary artery disease and aortic dissection when the patients are performed with Recurrent chest pain. When the diagnosis is confirmed, the drugs of Corticosteroids and immunosuppressants can be used as the preferred to control inflammation and vascular complications. According to the severity of the situation, consider the need for Endovascular surgery or Surgical repair of vascular complications during TA’s inactive stage. With better understanding of the disease, the clinical diagnosis and treatment would be more timely and specific, thereby improving patients’ prognosis and life quality by the analysis of this case combined with the literature.