Alali Wala M, Alahmari Saeed A, Alhebaishi Yahya S, Alrashidi Seham A
Department of Internal Medicine, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail:.
Saudi Med J. 2017 Aug;38(8):863-867. doi: 10.15537/smj.2017.8.12473.
We present an uncommon case of a 48-year-old female patient with symptomatic presentation of a severe aortic regurgitation with aneurysm of the ascending aorta and progressive dyspnea. Detailed investigation of laboratory tests and imaging identified Takayasu's arteritis (TA) as the underlying etiology. Computed tomography scan revealed complete occlusion of the right carotid artery as well as stenosis at the origins of left subclavian and vertebral arteries. In addition, cardiac magnetic resonance angiogram showed aneurysm at the proximal segment of right subclavian artery. Intervention with corticosteroids effectively diminished the need for immediate surgical intervention. Treating physicians should always consider differential diagnosis of TA in the presence of atypical clinical findings in all patients with cardiac problems especially when there is valve involvement.
我们报告了一例罕见病例，一名48岁女性患者，有严重主动脉瓣反流、升主动脉瘤及进行性呼吸困难的症状表现。实验室检查和影像学的详细调查确定大动脉炎（TA）为潜在病因。计算机断层扫描显示右侧颈动脉完全闭塞，以及左锁骨下动脉和椎动脉起始处狭窄。此外，心脏磁共振血管造影显示右侧锁骨下动脉近端段有动脉瘤。使用皮质类固醇进行干预有效地减少了立即进行手术干预的必要性。对于所有有心脏问题的患者，尤其是存在瓣膜受累的情况时，治疗医生在出现非典型临床发现时应始终考虑大动脉炎的鉴别诊断。
