Mitsuishi Atsuyuki, Tao Miyako, Edo Naoki, Saito Red, Miura Yujiro
Department of Cardiovascular Surgery, Kochi Medical School Hospital, Nankoku-shi, Japan.
Kochi Medical School, Nankoku-shi, Japan.
SAGE Open Med Case Rep. 2025 Aug 1;13:2050313X251360064. doi: 10.1177/2050313X251360064. eCollection 2025.
Patients with Takayasu arteritis may present with aortic dissection; however, pericardial effusion and atrioventricular block are rare manifestations of the disease. We present the case of a 51-year-old male with a 20-year history of ulcerative colitis. Two weeks before surgery, the patient experienced fever, and computed tomography revealed pericardial effusion along with thickening of the aorta, including its cervical branches. Based on clinical presentation and imaging findings, a diagnosis of Takayasu arteritis was established. Additionally, 8 days before surgery, the patient developed a complete atrioventricular block. We performed coronary computed tomography angiography to assess potential coronary artery involvement, which incidentally revealed an ascending aortic dissection. The patient subsequently underwent ascending aortic replacement surgery. The patient subsequently underwent ascending aortic replacement surgery. Although the relationship between these findings and the development to aortic dissection remains unclear, we report two atypical complications of Takayasu arteritis that subsequently progressed to aortic dissection as a third complication. This case emphasizes the importance of identifying atypical manifestations of Takayasu arteritis, as early recognition may facilitate timely diagnosis and intervention.
大动脉炎患者可能会出现主动脉夹层；然而，心包积液和房室传导阻滞是该疾病的罕见表现。我们报告一例51岁男性患者，有20年溃疡性结肠炎病史。手术前两周，患者出现发热，计算机断层扫描显示心包积液以及主动脉增厚，包括其颈部分支。根据临床表现和影像学检查结果，确诊为大动脉炎。此外，手术前8天，患者出现完全性房室传导阻滞。我们进行了冠状动脉计算机断层扫描血管造影以评估潜在的冠状动脉受累情况，偶然发现升主动脉夹层。患者随后接受了升主动脉置换手术。尽管这些发现与主动脉夹层发展之间的关系尚不清楚，但我们报告了大动脉炎的两种非典型并发症，随后这两种并发症进展为第三种并发症——主动脉夹层。该病例强调了识别大动脉炎非典型表现的重要性，因为早期识别可能有助于及时诊断和干预。
