Takayasu's arteritis history and symptoms: Difference between revisions

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==History==
==History==
The disease can be divided into two phases: a pre-pulseless phase and subsequent pulseless phase. In the initial phase is pre-pulseless phase, patients present with non-specific constitutional symptoms of vasculitis, which may include any of the following:<ref name="pmid7909656">{{cite journal |vauthors=Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS |title=Takayasu arteritis |journal=Ann. Intern. Med. |volume=120 |issue=11 |pages=919–29 |date=June 1994 |pmid=7909656 |doi= |url=}}</ref>
Takayasu's arteritis can be divided into two phases:<ref name="pmid7909656">{{cite journal |vauthors=Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS |title=Takayasu arteritis |journal=Ann. Intern. Med. |volume=120 |issue=11 |pages=919–29 |date=June 1994 |pmid=7909656 |doi= |url=}}</ref>
* Pre-pulseless phase
** Present with non-specific constitutional symptoms of vasculitis, which may include any of the following
*** [[Fatigue]]
*** [[Fever of unknown origin]]
*** [[Weight loss]]
*** [[Myalgia]]
*** [[Arthralgia]]


Fatigue
* Subsequent pulseless phase
 
** With progression of the disease and involvement of the branches of aorta, specific symptoms secondary to narrowing/occlusion of the branches of aorta become evident
Fever of unknown origin
** [[Subclavian artery]]: claudication in the upper extremities, subclavian steal syndrome
 
** Carotid and vertebral arteries: headache, vertigo, syncope, convulsions and dementia
Weight loss
** Coronary arteries: chest pain, angina which may progress to myocardial infarction
 
** Ascending aorta: aortic regurgiatation
Myalgia
 
Arthralgia
 
With progression of the disease and involvement of the branches of aorta,
 
specific symptoms secondary to narrowing/occlusion of the branches of aorta become evident.
* [[Subclavian artery]]: claudication in the upper extremities, subclavian steal syndrome
 
* Carotid and vertebral arteries: headache, vertigo, syncope, convulsions and dementia
 
* Coronary arteries: chest pain, angina which may progress to myocardial infarction
 
* Ascending aorta: aortic regurgiatation
Involvement of the [[subclavian artery]] is common and may lead to subclavian steal syndrome.<ref name="pmid15335">{{cite journal |vauthors=Yoneda S, Nukada T, Tada K, Imaizumi M, Takano T |title=Subclavian steal in Takayasu's arteritis. A hemodynamic study by means of ultrasonic Doppler flowmetry |journal=Stroke |volume=8 |issue=2 |pages=264–8 |date=1977 |pmid=15335 |doi= |url=}}</ref> In this syndrome, the stenosis of the subclavian artery, proximal to the origin of vertebral artery leads to the retrograde flow of blood from the vertebral artery back to subclavian artery during exercise, secondary to vasodilation of blood vessels. The retrograde flow of blood from the vertebral artery back towards subclavian compromises blood flow in the posterior cerebral bed, leading to various neurological symptoms including presyncope/syncope.
 
Additional findings include skin lesions resembling erythema nodosum, erythema multiforme, pyoderma gangrenosum. In advanced stages of the disease, the occlusion of the vessels in the extremities may lead to ischemic ulcerations.


===Common Symptoms===
===Common Symptoms===
Common symptoms of Takayasu's arteritis include:
Common symptoms of Takayasu's arteritis include:
* Headache
* Malaise
* Arthralgias
* Bruit, with the most common location being the carotid artery (80%)
* Blood pressure difference of extremities (45%-69%)
* Claudication (38-81%)
* Hypertension (28-53%; 58% with renal artery stenosis in one series
* Visual disturbance
===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of Takayasu's arteritis include:
* Fever
* Weight loss
* Carotodynia or vessel tenderness
* Raynaud syndrome
* Stroke (5-9%)
* Transient ischemic attacks (3-7%)
* Seizures 
* Erythema nodosum (6-19%)
* Ulcerated subacute nodular lesions (<2.5%)
* Pyoderma gangrenosum


==References==
==References==

Revision as of 20:06, 31 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]


Overview

History

Takayasu's arteritis can be divided into two phases:[1]

  • Subsequent pulseless phase
    • With progression of the disease and involvement of the branches of aorta, specific symptoms secondary to narrowing/occlusion of the branches of aorta become evident
    • Subclavian artery: claudication in the upper extremities, subclavian steal syndrome
    • Carotid and vertebral arteries: headache, vertigo, syncope, convulsions and dementia
    • Coronary arteries: chest pain, angina which may progress to myocardial infarction
    • Ascending aorta: aortic regurgiatation

Common Symptoms

Common symptoms of Takayasu's arteritis include:

  • Headache
  • Malaise
  • Arthralgias
  • Bruit, with the most common location being the carotid artery (80%)
  • Blood pressure difference of extremities (45%-69%)
  • Claudication (38-81%)
  • Hypertension (28-53%; 58% with renal artery stenosis in one series
  • Visual disturbance

Less Common Symptoms

Less common symptoms of Takayasu's arteritis include:

  • Fever
  • Weight loss
  • Carotodynia or vessel tenderness
  • Raynaud syndrome
  • Stroke (5-9%)
  • Transient ischemic attacks (3-7%)
  • Seizures 
  • Erythema nodosum (6-19%)
  • Ulcerated subacute nodular lesions (<2.5%)
  • Pyoderma gangrenosum

References

  1. ↑ Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, Hoffman GS (June 1994). "Takayasu arteritis". Ann. Intern. Med. 120 (11): 919–29. PMID 7909656.

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