Pulseless Disease and Atypical Coarctation of the Aorta

Pulseless disease (Takayasu's disease) was first recognized as a distinct clinical entity in Japan.1,2It is much more common in Japan than in the Western countries, so that in the past it has been considered peculiar to the Japanese. Recently, however, case reports in Europe and America have been increasing.3,4The pathogenesis of this disease is chronic arteritis afflicting the branches of the aortic arch. Although there have been found rather extensive lesions involving more than only the brachiocephalic branches of the aorta on autopsy, very few cases have been reported in the literature where pulsations were absent in the lower extremities. We have had a case of a young female patient with no pulsations in the extremities except in the right upper arm. This case is considered worth reporting because of its rarity and because it suggests some possibilities as to the etiology of atypical coarctation. The