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Takayasu’s arteritis with giant left ventricular pseudoaneurysm presenting as heart failure
  1. Frederick Berro Rivera1,
  2. Cecileen Anne M Tuazon2,
  3. Valerie R Ramiro2 and
  4. Maria Teresa Abola2
  1. 1Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, National Capital Region, Philippines
  2. 2Division of Cardiovascular Medicine, Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, National Capital Region, Philippines
  1. Correspondence to Dr Frederick Berro Rivera; frederick.berro.rivera{at}gmail.com

Abstract

Takayasu’s arteritis (TA) is a vasculitis with a predilection for young women. Left ventricular pseudoaneurysm (PSA) in TA is a rare phenomenon. We report a 36 years old Filipina who presented with heart failure symptoms. Years prior, she had a recurrent fever, headache, myalgia and left arm claudication. On workup, a 2D echo revealed a left ventricular PSA with mural thrombus and moderate mitral regurgitation. Cardiac MRI further characterised the PSA with a sac diameter of 8×7.5×8.4 cm (CC×T×AP). Carotid Duplex Scan revealed total occlusion of the mid to distal right common carotid artery and left subclavian artery. She was started on immunosuppresants and guideline-directed medical therapy (GDMT) for heart failure and subsequently underwent successful endoventricular patch closure and mitral valve repair. This case highlights the importance of actively searching for cardiac complications of TA which although very rare, can dominate the clinical picture and may carry a dismal prognosis if left untreated.

  • cardiothoracic surgery
  • vasculitis
  • heart failure

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Footnotes

  • Twitter @FredRiveraMD

  • Contributors Majority of the effort in making this case report was done by the primary author with the guidance of MTA, RF and CT.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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