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Takayasu arteritis

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Illustrations

Heart, section through the middle
Heart, section through the middle

Alternative names    Return to top

Pulseless disease

Definition    Return to top

Takayasu arteritis is an inflammmation of the aorta and its major branches.

Causes, incidence, and risk factors    Return to top

The cause of Takayasu arteritis is unknown. The disease occurs primarily in children and young women younger than 30, many of whom are of Asian or African descent. It appears to be an autoimmune condition, where immune cells are wrongly targeted against the body's own tissues, and may involve other systems.

Because of changes in the aorta and its branches that feed the head, neck, and upper limb areas, patients may have decreased or absent radial pulses (pulse in the wrist) and pain in the arm and forearm. Inflammation in the carotid arteries (large arteries in the neck that supply blood to the brain) may cause visual problems or neurological problems such as dizziness or stroke. Decreased blood flow to the kidneys often causes hypertension (high blood pressure). The formation of aneurysms may lead to rupture of the affected vessel.

Systemic complaints may include fever, rash, muscle aches (myalgia), and arthritis. Chest pain can develop due to inflammation of either the lining of the chest cavity (pleuritis) or the sac-like covering of the heart (pericarditis), or due to heart attack (myocardial infarction).

The survival rate is better for adults than for children.

Symptoms    Return to top

Signs and tests    Return to top

There may also be signs of inflammation (pericarditis or pleuritis).

Tests:

Treatment    Return to top

Treatment of Takayasu arteritis is difficult, but results with appropriate therapy are encouraging. Early detection is important. Steroids and immunosuppressive agents form the cornerstone of treatment, with surgery reserved for complications caused by narrowed arteries.

Surgery to bypass narrowed arteries may be necessary to supply blood beyond the constriction.

Expectations (prognosis)    Return to top

This disease can be fatal. However, with a combination of aggressive medical and surgical therapy, mortality (death) rates have dropped dramatically. In well-managed cases of Takayasu arteritis, the long-term survival rate is greater than 90%.

Complications    Return to top

Calling your health care provider    Return to top

Call your health care provider if you have symptoms of this condition. Weak pulse, chest pain, and breathing difficulty require immediate care.

Update Date: 4/26/2004

Updated by: Stanford Peng, M.D., Ph.D., Division of Rheumatology, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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