Rangel-Abundis A, Fraga A, Badui E, Guijosa N, Navarro J
Departamento de Hemodinámica, C.M. La Raza, IMSS, México, D.F.
Arch Inst Cardiol Mex. 1992 Jan-Feb;62(1):33-43.
The most severe arteritis due to Takayasu's disease are those related to renal and coronary arteries. The first one because it produces severe arterial hypertension and the second one because it puts the patient in high risk of suffering either myocardial ischemia or infarction. These situations worsen when this entity is associated to valvular heart lesions. The authors present the clinical cases of two female patients with Takayasu's disease. One of them in acute phase of the illness, where coronary arteritis, mild coarctation of the aorta, right pulmonary artery stenosis, and pulmonary valve stenosis were present. The second patient was seen during the remission phase of the disease with obstruction of the left subclavicular artery, renal arteritis, severe arterial hypertension and aortic valve insufficiency. The authors discuss the prognosis of patients with Takayasu's disease associated to valvular heart disease and its role in the etiology of pulmonary valvular stenosis. Finally, the authors point out the importance of recognizing the active and non active phases of the Takayasu's disease in relation of the adequate stage for surgical treatment of the lesions caused by this disease.
大动脉炎最严重的情况是与肾动脉和冠状动脉相关的病变。前者会导致严重的动脉高血压，后者则使患者面临心肌缺血或梗死的高风险。当该疾病与心脏瓣膜病变相关时，这些情况会恶化。作者介绍了两名大动脉炎女性患者的临床病例。其中一名处于疾病急性期，存在冠状动脉炎、轻度主动脉缩窄、右肺动脉狭窄和肺动脉瓣狭窄。第二名患者在疾病缓解期就诊，有左锁骨下动脉阻塞、肾动脉炎、严重动脉高血压和主动脉瓣关闭不全。作者讨论了大动脉炎合并心脏瓣膜病患者的预后及其在肺动脉瓣狭窄病因中的作用。最后，作者指出认识大动脉炎的活动期和非活动期对于确定该疾病所致病变的合适手术治疗阶段的重要性。
