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Background: 1) Takayasu arteritis is an inflammatory and stenotic disease of medium & large sized vessel with strong predilection for aortic arch. 2) It is caused by intimal proliferation, fibrosis, scarring of arterial tunica media results in blood flow compromisation of involved organs. Case Presentation: A 30 year old female presented with 2 months history of continuous headache associated with dizziness, devoid of phonophobia, photophobia, fever, weight loss, chest pain and palpitation. 2) On general examination, pulse was feeble in left upper limb with radio -radial delay and feeble pulses in both lower limbs with discrepancy of blood pressure in all four limbs. 3) On cardiovascular system examination, grade 3/6 systolic murmur heard at aortic & pulmonic area, radiating to bilateral carotid artery and precordium and continuous murmur heard at inter -scapular area. 4) 2D -echo suggestive of severe juxtaductal coarctation of aorta with Gmax of 79mmhg. 5) CT aortogram suggestive of severe narrowing in aortic isthmus 20mm distal to left subclavian artery, severe osteal stenosis involving left common carotid and subclavian artery. 6) Patient was treated with revascularization procedure (PTA) & anti -inflammatory therapy with glucocorticoid and mycophenolate mofetil. Conclusion: 1) Coarctation of aorta was suspected with thorough clinical examination and early diagnosis was possible even in the absence of typical features of vasculitis that makes favourable outcome.
Megha Maheshbhai Patel Dhruv (Fri,) studied this question.