Symptoms of Takayasu's disease

Non-specific aortoarteritis is characterized by general inflammatory manifestations and a combination of various syndromes: peripheral blood flow insufficiency, cardiovascular, cerebrovascular, abdominal, pulmonary, arterial hypertension. The classic symptom of Takayasu's disease is the syndrome of asymmetry or absence of pulse.

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General symptoms of Takayasu's disease

Takayasu's disease has two phases: acute, lasting from several weeks to several months, and chronic - with or without exacerbations. At the onset of the acute phase, subfebrile temperature or unmotivated febrile "candles", fatigue, intermittent muscle pain (during physical exertion), erythema nodosum or hemorrhages on the skin are observed. Over the course of many months, an increased ESR (up to 50-60 mm/h) is determined. After several months, depending on the localization of the pathological process, certain characteristic symptoms and syndromes appear.

Localization of aortoarteritis and clinical syndromes

Localization of the pathological process	Clinical syndromes
Subclavian, brachial, femoral, popliteal arteries	Intermittent claudication syndrome. Syndrome of asymmetry or absence of pulse. Pathological vascular sounds.
Carotid arteries	Headache. Vision impairment, retinopathy. Cerebrovascular accident. Vascular noise over the carotid arteries.
Pulmonary arteries	Pulmonary hypertension
Renal arteries	Renal hypertension
Celiac, mesenteric arteries	Abdominal pain, vomiting, diarrhea

Peripheral blood flow insufficiency syndrome reflects ischemia below the site of stenosis or occlusion of a large artery and manifests itself as "intermittent" pain. Pain during exertion in one or both arms or legs with a feeling of fatigue and numbness of the fingers occurs with damage to the subclavian or iliac (femoral) arteries; back pain - with damage to the vertebral arteries. The most important for diagnosis syndrome is asymmetry or absence of pulse and arterial pressure. Most often, the pulse is not detected on the left radial artery.

Cardiovascular syndrome. In the presence of cardiovascular syndrome, pain along the vessels is characteristic, murmurs are heard over narrowed but passable arteries (over the aorta and large vessels). In case of damage to the coronary arteries, pain syndrome may occur, but more often patients do not present typical complaints of pain in the heart area. In case of damage to the ascending aorta, compaction, dilation, and sometimes the formation of an aneurysm are detected, which can lead to aortic insufficiency. The coronary arteries with corresponding symptoms may be involved in the pathological process. Increased blood pressure is combined mainly with damage to the renal arteries.

Cerebrovascular syndrome is usually observed in patients with damage to the vessels of the aortic arch and its carotid and brachiocephalic branches. Neurological disorders are often the first signs of the disease. The most common are headache, fainting, cerebrovascular accident and visual impairment. Examination of the fundus reveals narrowing of the arteries, dilation of the veins, and arteriovenous anastomoses.

Abdominal syndrome in the form of attacks of abdominal pain, often with vomiting and diarrhea, is observed with damage to the abdominal aorta and mesenteric vessels. When an aneurysm of the abdominal aorta occurs, a pulsating formation is palpated in the abdominal cavity, over which vascular noise is heard.

Pulmonary syndrome in nonspecific aortoarteritis in children rarely has clinical manifestations (cough, hemoptysis, recurrent pneumonia); radiologically, deformation of the vascular-interstitial pulmonary pattern, expansion of the roots, adhesive changes in the pleural sheets may be noted, and according to ECG data, signs of pulmonary hypertension.

Arterial hypertension syndrome is a consequence of renal artery damage. Blood pressure increases several months after the onset of the disease and is sometimes combined with moderate progeinuria.

Course of Takayasu's disease

When the acute phase turns into a chronic phase, the body temperature normalizes, the condition becomes satisfactory, and children lead a normal life. However, some of them experience dizziness and fainting when changing body position (carotid syndrome), decreased visual acuity, and ischemic phenomena in the limbs. In most cases, examination reveals asymmetry or absence of pulse and blood pressure in one of the limbs, vascular noises, and in some cases, arterial hypertension. During periods of exacerbation, the pathological process resumes in the same place or spreads to previously intact sections of the aorta. In the first case, aortic wall dissection or aneurysms with the risk of rupture of this section may occur, while in the second case, previously unknown syndromes of the disease appear.

Complications of Takayasu's disease

Complications of Takayasu's disease depend on the location and nature of the vascular lesion. The most serious of them are: stroke, myocardial infarction, chronic renal failure, heart failure, aortic aneurysm dissection, which can also be the main causes of death in patients with nonspecific aortoarteritis.

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