Arteritis of Takayasu in Western man of 31 years

Arteritis of Takayasu in Western man of 31 years 2216 T.D. Henry et al. 29. Fisher SA, Dore ´e C, Brunskill SJ, Mathur A, Martin-Rendon E, Zheng Y. Bone mar- 33. Wang S, Cui J, Peng W, Lu M. Intracoronary autologous CD34þ stem cell ther- row stem cell treatment for ischemic heart disease in patients with no option of . apy for intractable angina. Cardiology 2010;117:140–147. revascularization: a systematic review and meta-analysis. PLoS One 2013;8:e64669. 34. Quyyumi AA, Vasquez A, Kereiakes DJ, Klapholz M, Schaer GL, Abdel-Latif A, 30. Khan AR, Farid TA, Pathan A, Tripathi A, Ghafghazi S, Wysoczynski M, Bolli R. Frohwein S, Henry TD, Schatz RA, Dib N, Toma C, Davidson CJ, Barsness GW, Impact of cell therapy on myocardial perfusion and cardiovascular outcomes in Shavelle DM, Cohen M, Poole J, Moss T, Hyde P, Kanakaraj AM, Druker V, patients with angina refractory to medical therapy: a systematic review and . Chung A, Junge C, Preti RA, Smith RL, Mazzo DJ, Pecora A, Losordo DW. meta-analysis. Circ Res 2016;118:984–993. PreSERVE-AMI: a randomized, double-blind, placebo-controlled clinical trial of 31. Kandala J, Upadhyay GA, Pokushalov E, Wu S, Drachman DE, Singh JP. Meta- intracoronary administration of autologous CD34þ cells in patients with left analysis of stem cell therapy in chronic ischemic cardiomyopathy. Am J Cardiol ventricular dysfunction post STEMI. Circ Res 2017;120:324–331. 2013;112:217–225. . 35. Vrtovec B, Poglajen G, Lezaic L, Sever M, Domanovic D, Cernelc P, Socan A, 32. Li N, Yang YJ, Zhang Q, Jin C, Wang H, Qian HY. Stem cell therapy is a promis- Schrepfer S, Torre-Amione G, Haddad F, Wu JC. Effects of intracoronary ing tool for refractory angina: a meta-analysis of randomized controlled trials. CD34þ stem cell transplantation in nonischemic dilated cardiomyopathy Can J Cardiol 2013;29:908–914. . patients: 5-year follow-up. Circ Res 2013;112:165–173. doi:10.1093/eurheartj/ehy131 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 22 March 2018 .................................................................................................................................................... 1 2 2 1 Jose ´ Werenitzky *, Augusto Jose ´ Lepori , Mat ıas Horacio Clavero , Alvaro Carranza , 1 1 Fabian  Islas , and Jose ´ Alberto de Agustin 1 2 Cardiovascular Institute, Hospital Universitario San Carlos, Profesor Martin Lagos s/n, Madrid 28040, Spain; and Cardiovascular Image Service of Sanatorio Allende, Obispo oro 46, Cordoba  5000, Argentina * Corresponding author. Tel: 134 662535911, Fax: 0034913303290, Email: josewerenitzky@gmail.com We present the case of a 31-year-old Caucasian male, which was being studied in the emergency department for two episodes of syncope. The patient had a history of pain, coldness and paraesthesia of the right arm, jaw claudication, and intense headaches. He was being treated with two antihypertensive drugs due to arterial hypertension. Physical examination showed a differential arterial blood pressure between the arms (right 95/40, left 170/100), carotid systolic murmur in both sides of the neck, both supraclavicular spaces, and mesogastrium as well. Carotid and radial arteries pulses amplitude was diminished. Doppler sonography revealed several lesions in different vascular territo- ries so the patient was sent for magnetic resonance angiography and a computed tomography angiography, revealing obstructions in the brachiocephalic artery, subclavian and vertebral arteries of both vascular territories which are marked with arrows (Panel A). Panel B shows that the carotid arteries are supplied by circulatory collateral through the polygon of Willis. The descending aorta was not affected (Panel C), but the right renal artery and the lower renal lobe the arteries had severe obstructions (Panel D). The wall of the aortic arch marked with an arrow shows an increase in thickness due to inflammation (Panel E). After several tests patient was diagnosed of Takayasu arteritis. He was treated with corticosteroids and percutaneous peripheral arteries interventions with good result and excellent clinical out- come. We report this case because the uncommon nature of Takayasu arteritis in western men, and its extensive vascular damage. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/eurheartj/article-abstract/39/23/2216/4951578 by Ed 'DeepDyve' Gillespie user on 21 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Heart Journal Oxford University Press
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Oxford University Press
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.
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0195-668X
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1522-9645
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10.1093/eurheartj/ehy131
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Abstract

2216 T.D. Henry et al. 29. Fisher SA, Dore ´e C, Brunskill SJ, Mathur A, Martin-Rendon E, Zheng Y. Bone mar- 33. Wang S, Cui J, Peng W, Lu M. Intracoronary autologous CD34þ stem cell ther- row stem cell treatment for ischemic heart disease in patients with no option of . apy for intractable angina. Cardiology 2010;117:140–147. revascularization: a systematic review and meta-analysis. PLoS One 2013;8:e64669. 34. Quyyumi AA, Vasquez A, Kereiakes DJ, Klapholz M, Schaer GL, Abdel-Latif A, 30. Khan AR, Farid TA, Pathan A, Tripathi A, Ghafghazi S, Wysoczynski M, Bolli R. Frohwein S, Henry TD, Schatz RA, Dib N, Toma C, Davidson CJ, Barsness GW, Impact of cell therapy on myocardial perfusion and cardiovascular outcomes in Shavelle DM, Cohen M, Poole J, Moss T, Hyde P, Kanakaraj AM, Druker V, patients with angina refractory to medical therapy: a systematic review and . Chung A, Junge C, Preti RA, Smith RL, Mazzo DJ, Pecora A, Losordo DW. meta-analysis. Circ Res 2016;118:984–993. PreSERVE-AMI: a randomized, double-blind, placebo-controlled clinical trial of 31. Kandala J, Upadhyay GA, Pokushalov E, Wu S, Drachman DE, Singh JP. Meta- intracoronary administration of autologous CD34þ cells in patients with left analysis of stem cell therapy in chronic ischemic cardiomyopathy. Am J Cardiol ventricular dysfunction post STEMI. Circ Res 2017;120:324–331. 2013;112:217–225. . 35. Vrtovec B, Poglajen G, Lezaic L, Sever M, Domanovic D, Cernelc P, Socan A, 32. Li N, Yang YJ, Zhang Q, Jin C, Wang H, Qian HY. Stem cell therapy is a promis- Schrepfer S, Torre-Amione G, Haddad F, Wu JC. Effects of intracoronary ing tool for refractory angina: a meta-analysis of randomized controlled trials. CD34þ stem cell transplantation in nonischemic dilated cardiomyopathy Can J Cardiol 2013;29:908–914. . patients: 5-year follow-up. Circ Res 2013;112:165–173. doi:10.1093/eurheartj/ehy131 CARDIOVASCULAR FLASHLIGHT Online publish-ahead-of-print 22 March 2018 .................................................................................................................................................... 1 2 2 1 Jose ´ Werenitzky *, Augusto Jose ´ Lepori , Mat ıas Horacio Clavero , Alvaro Carranza , 1 1 Fabian  Islas , and Jose ´ Alberto de Agustin 1 2 Cardiovascular Institute, Hospital Universitario San Carlos, Profesor Martin Lagos s/n, Madrid 28040, Spain; and Cardiovascular Image Service of Sanatorio Allende, Obispo oro 46, Cordoba  5000, Argentina * Corresponding author. Tel: 134 662535911, Fax: 0034913303290, Email: josewerenitzky@gmail.com We present the case of a 31-year-old Caucasian male, which was being studied in the emergency department for two episodes of syncope. The patient had a history of pain, coldness and paraesthesia of the right arm, jaw claudication, and intense headaches. He was being treated with two antihypertensive drugs due to arterial hypertension. Physical examination showed a differential arterial blood pressure between the arms (right 95/40, left 170/100), carotid systolic murmur in both sides of the neck, both supraclavicular spaces, and mesogastrium as well. Carotid and radial arteries pulses amplitude was diminished. Doppler sonography revealed several lesions in different vascular territo- ries so the patient was sent for magnetic resonance angiography and a computed tomography angiography, revealing obstructions in the brachiocephalic artery, subclavian and vertebral arteries of both vascular territories which are marked with arrows (Panel A). Panel B shows that the carotid arteries are supplied by circulatory collateral through the polygon of Willis. The descending aorta was not affected (Panel C), but the right renal artery and the lower renal lobe the arteries had severe obstructions (Panel D). The wall of the aortic arch marked with an arrow shows an increase in thickness due to inflammation (Panel E). After several tests patient was diagnosed of Takayasu arteritis. He was treated with corticosteroids and percutaneous peripheral arteries interventions with good result and excellent clinical out- come. We report this case because the uncommon nature of Takayasu arteritis in western men, and its extensive vascular damage. V C Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: journals.permissions@oup.com. Downloaded from https://academic.oup.com/eurheartj/article-abstract/39/23/2216/4951578 by Ed 'DeepDyve' Gillespie user on 21 June 2018

Journal

European Heart JournalOxford University Press

Published: Mar 22, 2018

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