Cardiac manifestations of Takayasu's arteritis: five case reports

Purpose. - Cardiac manifestations of Takayasu's arteritis are rarely report ed in the literature. However, these symptoms are not rare and when they do occur, they determine the disease prognosis. Due to its frequency its seve re nature, and even sometimes diagnosis failure, high blood pressure is the major cause of cardiac manifestations. More specific cardiac manifestation s of either coronary valvular, or more rarely, myocardial origin may also o ccur. Methods. - Analysis of five cases of Takayasu's arteritis and a literature review allowed evaluation of both the frequency and characteristics of this disease. Results. - Four female and one male patients presenting with symptoms of Ta kayasu's arteritis, according to Fiessinger's score, were evaluated. Diagno sis of cardiac disease was based on clinical, echocardiographic and angiogr aphic criteria. Four patients had related high blood pressure. Valvular man ifestations were present in all the patients. They included mitral insuffic iency (1 case); aortic insufficiency (2 cases), and both mitral and aortic insufficiency (2 cases). Two patients showed clinical manifestations of myo cardiac disease, and another showed coronary signs. Treatment did not invol ve surgery, including only antihypertensive drugs, nitrites, and diuretics associated with digitalin in case of cardiac failure. The disease outcome, including a 5-18 year follow-up, involved symptom decrease in all the patie nts. Conclusion. - Despite the rarity of cardiac manifestations in patients suff ering front Takayasu's arteritis, symptoms of this disease should always be investigated, as these,manifestations alter the prognosis. Aortic insuffic iency is the most frequently encountered cardiac manifestation. (C) 1999 El sevier, Paris.