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Everything You Should Know About Takayasu’s Arteritis

Overview

Takayasu’s arteritis is an uncommon blood vessel disease. It usually leads to damage to the aorta. The aorta is the largest artery in your body. It can also affect your other large arteries, causing them to narrow or weaken.

This disease is an example of vasculitis, a collection of conditions that cause blood vessel inflammation.

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Symptoms

Symptoms

Most of the symptoms of Takayasu’s arteritis are vague, such as fatigue and chest pain. They are signs shared by many health problems. Doctors can use your symptoms to classify the stage of the disease.

Stage 1 symptoms

Symptoms in the first stage of the disease include:

  • fatigue
  • unexplained and rapid weight loss
  • muscle and joint pain
  • mild fever

Damage to the arteries might have started long before it’s discovered. It could be more than a year before your symptoms advance to stage 2.

Stage 2 symptoms

Once you’ve entered the second stage of the disease, you may experience the following additional symptoms:

  • weakness or pain in your limbs
  • lightheadedness or dizziness
  • trouble concentrating
  • vision problems
  • high blood pressure
  • difference in blood pressure between both arms
  • anemia
  • chest pain
  • shortness of breath

Stage 2 symptoms result from restricted blood flow from your heart to certain organs, muscles, and other tissue.

A third stage is defined by the resolution of these symptoms, though this is a result of scarring in the blood vessels.

Causes

Causes

It’s unclear what causes Takayasu’s arteritis. It may be a type of autoimmune disease in which the body’s immune system attacks healthy arteries by mistake. A bacterial or viral infection may trigger that response in people with a vulnerable immune system. However, there is no strong research yet to support this idea.

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Risk factors

Risk factors

Takayasu’s arteritis affects only about 2 to 3 people out of 1 million annually. The disease is much more common in women than in men. Women younger than 40 and people of Asian descent are the most vulnerable. It may run in families.

There are no other obvious risk factors. If you were successfully treated for the disease, you’re still at risk for a recurrence.

Seek help

Seeing a doctor

Any time you feel sudden chest pain or can’t catch your breath, you should seek medical attention right away. Those are classic signs of a heart attack and other cardiac problems. If you start to experience stroke symptoms, you should also get to an emergency room by ambulance.

Stroke symptoms include:

  • face drooping on one side
  • weakness in one or both arms
  • speech difficulty
  • difficulty understanding other people
  • sudden, severe headache
  • loss of coordination
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Diagnosis

Diagnosis

Diagnosing Takayasu’s arteritis isn’t easy because the symptoms are like those of other cardiovascular issues. Sometimes multiple tests are done to help rule out other conditions, as well as pinpoint the problem. Some of the most common tests done to diagnose Takayasu’s arteritis are:

Angiography

A thin, flexible catheter is inserted into a blood vessel and a special dye is injected into your bloodstream through the catheter. Then X-rays are taken to view how blood is flowing through your veins and arteries. An angiogram can reveal blood vessels that have narrowed. With Takayasu’s arteritis, typically more than one artery is narrowed.

Magnetic resonance angiography (MRA)

Instead of using a catheter and X-rays, this test uses a magnetic field and radio waves to create pictures of your blood vessels. A contrast dye is usually injected through an intravenous (IV) line.

Blood tests

There may be markers of inflammation in your blood that could indicate Takayasu’s arteritis. One of the main inflammatory markers is C-reactive protein. Learn more about C-reactive protein tests.

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Treatment

Treatment

A thorough treatment of Takayasu’s arteritis focuses on reducing inflammation and preventing continued damage to artery walls. In minor cases, no medications may be needed.

In more serious cases, corticosteroids, such as prednisone, are given at high doses at first. During the next several weeks or months, the dosage is lowered. Cytotoxic drugs, such as methotrexate and azathioprine (Azasan, Imuran), are helpful in reducing the response of your immune system. Cytotoxic drugs are also commonly used to fight cancer.

Biologics may also be used. Biologics are drugs that affect the immune system in a different way. Medications such as rituximab (Rituxan) and infliximab (Inflectra, Remicade) target immune system abnormalities and may help treat symptoms if other medications aren’t effective.

When medications aren’t enough to treat your circulation problems, various procedures may be needed. If, for example, the arteries that supply blood to your heart muscle are significantly narrowed, you may need a coronary artery bypass graft. This surgery involves the attachment of a blood vessel taken from elsewhere in the body to a blocked artery in your heart. That allows blood to be rerouted around the blockage.

Arterial blockage may also be treated with balloon angiography. In this procedure, a catheter is inserted in a blood vessel and guided to the site where an artery has narrowed. At the tip of the catheter is a deflated balloon. After insertion, the balloon is inflated where the artery has narrowed. This helps open the artery. Sometimes a flexible mesh tube, called a stent, is left in place to keep the artery open.

Takayasu’s arteritis can also damage the aortic valve in your heart. Valve repair or replacement procedures are also needed when the disease has caused the valve to stop operating properly.

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Complications

Complications

Flare-ups of Takayasu’s arteritis inflammation can wreak havoc on your arteries. The arteries can thicken, narrow, weaken, and grow stiffer. Scars can also develop inside arteries. This damage to your arteries can lead to a variety of complications, depending on the severity of the damage and the particular blood vessel that’s affected.

Some of the more common complications associated with Takayasu’s arteritis include:

  • Hardened arteries: When arteries get narrower and less flexible, blood flow drops to organs and other tissue.
  • High blood pressure: Less blood flow to your kidneys usually results in higher blood pressure.
  • Myocarditis: Inflammation of the heart muscle can then lead to heart rhythm disturbances and other problems.
  • Heart failure: With this condition, your heart muscle grows too weak to pump blood effectively throughout your body.
  • Stroke: The interruption of blood flow to your brain is a stroke, which can affect speech, thinking skills, motor control, and other aspects of your health.
  • Aortic aneurysm: When a wall of your aorta weakens and bulges outward, the result is an aortic aneurysm. This raises the risk of your aorta rupturing and causing a potentially fatal bleeding incident.
  • Heart attack: A heart attack results when blood flow to your heart muscle is reduced. Heart muscle tissue can be permanently damaged.

In pregnancy

Takayasu’s arteritis can complicate fertility and pregnancy, though it’s still possible to have a healthy pregnancy with this condition. Some of the medications used to treat the disease may interfere with getting pregnant and having a healthy pregnancy, however. If you’re planning to get pregnant, talk with your doctor about treatment and how you can avoid pregnancy complications.

Outlook

Outlook

Takayasu’s arteritis can usually be controlled with medications. However, those drugs are strong and have potential side effects. To have the best quality of life possible, work with your doctor on ways to reduce side effects. Ask whether low-dose daily aspirin therapy is right for you.

It’s also important to live a heart-healthy lifestyle. That means no smoking, which can damage your blood vessels. It also requires regular exercise and a healthy diet that focuses on fruits, vegetables, whole grains, and lean proteins. Read more about the effects of diet on heart health.

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