Secondary Hypertension Due to Underlying Takayasu Arteritis

A young female patient in her early 20s of Hispanic descent presented to the hospital with new-onset chest pain and uncontrolled hypertension. She was found to have blood pressure in the 200s/100s. She was evaluated for causes of secondary hypertension and underwent computed tomography angiography (CTA) of her abdomen to rule out fibromuscular dysplasia, which showed abnormal thickening of lower thoracic and abdominal aorta extending into both renal arteries causing stenosis. This finding led to further investigations, and she was found to have elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Magnetic resonance angiography (MRA) was done, which confirmed the findings of periaortitis in the vessels as described above. A diagnosis of Takayasu arteritis (TA) was made, and the patient was treated with high-dose steroids with significant improvement in her symptoms.