Author + information
- Received February 20, 2009
- Accepted February 25, 2009
- Published online August 11, 2009.
A 24-year-old woman was admitted to the hospital by her general practitioner because of pulselessness in the upper extremities. Except for chronic lower back pain, arthralgia, fatigue, and a loud systolic murmur, clinical symptoms were moderate. The initial echocardiogram suspected a malformation of the vessels deriving from the aortic arch and showed signs of concentric left ventricular hypertrophy. A magnetic resonance angiography of the thoracic aorta, neck, and head revealed the left subclavian (*), common carotid (**), and vertebral (***)arteries truncated (A). The right subclavian (°) (A)and vertebral (°°) (B)arteries displayed proximal filiform stenoses. The vessel walls showed massive thickening, and laboratory analyses showed signs of a chronic inflammation. Takayasu arteritis was diagnosed, and the patient was treated with glucocorticoids. After a mere 5 days of treatment, she reported a dramatic improvement in general condition and a first-time decrease of the chronic back pain. Unfortunately, no improvement in perfusion of the obstructed vessels has been noted thus far (4 weeks).
- Received February 20, 2009.
- Accepted February 25, 2009.
- American College of Cardiology Foundation