Symptoms of Takayasu's disease

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

[1], [2], [3], [4]

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. In the debut of the acute phase, subfebrile or unmotivated febrile "candles" are observed, fatigue, pain in the muscles of an intermittent nature (with physical activity), erythema nodosum or hemorrhages on the skin. For many months, an increased ESR (up to 50-60 mm / h) is determined. In a few months, depending on the localization of the pathological process, these or other characteristic symptoms and syndromes appear.

Localization of aortoarteritis and clinical syndromes

Localization of the pathological process	Clinical syndromes
Subclavian, humeral, femoral, popliteal arteries	Syndrome of intermittent claudication. Syndrome of asymmetry or lack of pulse Pathological vascular noise
Sleepy arteries	Headache. Visual impairment, retinopathy. Violation of cerebral circulation. Vascular noise above the carotid arteries
Pulmonary arteries	Pulmonary hypertension
Renal arteries	Renal Hypertension
Ciliary, mesenteric arteries	Abdominal pain, vomiting, diarrhea

The syndrome of peripheral blood flow insufficiency reflects ischemia below the site of stenosis or occlusion of the major artery and manifests as "intermittent" pain. Pain when loaded in one or both arms or legs with a feeling of fatigue and numbness of the fingers occur in the defeat of the subclavian or iliac (femoral) arteries; pain in the back - with lesions of the vertebral arteries. The most important for diagnosis is the syndrome of asymmetry or lack of pulse and blood pressure. Most often, the pulse is not detected on the left radial artery.

Cardiovascular syndrome. In the presence of cardiovascular syndrome, pains along the course of the vessels are characteristic, noises (above the aorta and large vessels) are heard above the narrowed but passable arteries. In the case of coronary artery disease, pain may occur, but more often patients do not present typical complaints of pain in the region of the heart. When the ascending aorta is affected, compaction, dilatation, and sometimes the formation of an aneurysm, can lead to aortic insufficiency. In the pathological process, coronary arteries with the corresponding symptomatology may be involved. The increase in blood pressure is combined mainly with the defeat of the renal arteries.

Cerebrovascular syndrome is usually observed in patients with vascular lesions in the area of the aortic arch and its carotid and brachiocephalic branches. Often, neurological disorders are the first signs of the disease. The most common headache, fainting, cerebral circulation and visual impairment. When examining the fundus, arteries narrowing, veins, arteriovenous anastomoses are revealed.

Abdominal syndrome in the form of bouts of pain in the abdomen, often with vomiting and diarrhea, observed with lesions of the abdominal aorta and mesenteric vessels. When an aneurysm of the abdominal aorta arises in the abdominal cavity, a pulsating formation is palpated, above which vascular noise is heard.

Pulmonary syndrome with nonspecific aortoarteritis in children rarely has clinical manifestations (cough, hemoptysis, relapsing pneumonia), roentgenologically can be noted deformation of the vascular interstitial lung pattern, enlargement of the roots, adhesive changes in pleural sheets, and according to ECG - signs of pulmonary hypertension.

Syndrome of arterial hypertension is a consequence of defeat of the renal arteries. Arterial pressure rises after a few months from the onset of the disease and is sometimes combined with moderate progeinuria.

The course of Takayasu's disease

With the transition of the acute phase into a chronic body temperature normalizes, the state becomes satisfactory, children lead a normal lifestyle. However, some of them notice dizziness and fainting with a change in body position (carotid syndrome), reduced visual acuity, ischemic events in the limbs. On examination, in most cases, asymmetry or lack of pulse and blood pressure is detected on one of the limbs, vascular noise, and in some cases - arterial hypertension. During periods of exacerbations, the pathological process resumes in the same place or spreads to intact previously aortic departments. In the former case may occur delamination aortic wall l occurrence of aneurysms with risk of rupture portion, the second appear not to have been previously disease syndromes.

Complications of Takayasu's disease

Complications of Takayasu's disease depend on the localization 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 of patients with nonspecific aortoarteritis.

[5], [6], [7], [8], [9], [10], [11]